Ask Dr. Mike: Supplements You Should NEVER Mix & Intestinal Overgrowth

Here you'll find the answers to a wealth of health and wellness questions posed by Healthy Talk fans.

Listen in because what you know helps ensure healthy choices you can live with. Today on Healthy Talk, you wanted to know:

I sometimes feel like a mad scientist in my own personal experiments as I mix several supplements into a drink and toss it back. Currently, before I go out for my hikes I mix L-carnitine, d-ribose, MSM, and natural calm into a drink and it actually tastes okay. I feel like I can actually hike and climb longer with lower heart rates when I take this. The question is this: are there supplements that should never be mixed together?

There are two ways to think about this, and one of them is pharmacokinetic. This is how something is digested, distributed, absorbed, and eliminated from your body. So, if you're mixing things together, does this change the kinetics of that compound? On the other hand, there's an pharmacodynamics perspective... is it going to increase or lower the response of the supplement?

Dr. Mike is going to answer with a pharmacokinetic response. You need to be cautious when mixing calcium, magnesium, and zinc together, since calcium blocks the absorption of zinc and magnesium.

Another bad combination is creatine and glutamine, as they use the same co-transporters and end up competing with one another. If you take them together, you might lose the cellular effect. Vitamin E and iron is another combo that you shouldn't mix, because iron can disrupt vitamin E absorption.

From a pharmacodynamics standpoint, Dr. Mike would never start someone on rhodiola and DHEA because it might overstimulate.

Everyone is taking probiotics these days. As I understand, the small intestine is supposed to be almost sterile and the colon is supposed to be lined with the desirable probiotic. More is being talked about small intestinal overgrowth, where the normally bacteria-free small intestine becomes overgrown with bacteria. This seems to cause bloating and gas. I am unclear: if we swallow large amounts of bacteria, how is it that most people don't develop small intestinal bacteria overgrowth?

You internal digestive system is covered in probiotics, all the way from your throat to your anus. The reason why you don't see intestinal overgrowth when people are taking probiotics is because in the small bowel, there's a layer of bicarbonate that protects any seeping from your stomach acid coming into your small bowel.

If you have a health question or concern, Dr. Mike encourages you to write him at askdrmikesmith@radiomd.com or call in, toll-free, to the LIVE radio show (1.844.305.7800) so he can provide you with support and helpful advice.