Supplements and vitamins

During spring and summer, most people will get all the vitamin D they need from sunlight. But in winter we have to get it from our food. It can be hard to get enough vitamin D this way. Taking a vitamin D supplement will make sure that you are getting enough in the darker months.

The NHS recommends taking 10 micrograms of vitamin D. On some packs this will be written as 400IU. IU stands for international units. It is usually fine to take a bit more than this. But taking very high doses of vitamin D can be dangerous. Unlike some other vitamins, your body cannot easily get rid of vitamin D. So it can build up. This can cause symptoms including feeling or being sick and feeling very weak. In severe cases it can cause damage to your kidneys.

If you are not able to go outside very often you might need to take extra vitamin D in the summer as well. For example if you are in hospital for a long time.

The NHS recommends that you should take extra folic acid if you are trying to become pregnant. Or if you are in the first 12 weeks (first trimester) of pregnancy. You should take 400 micrograms, once every day. In some cases your doctor or midwife will tell you to take a little bit more than that.

Folic acid supplements are safe for most people. But they can cause problems for people with some medical conditions. They can also change the way some other medicines work. So always talk to your doctor before taking extra folic acid if you have a health condition.

You might need to take a calcium supplement if you take some types of medicine. Most commonly strong steroid medicines. This is because the medicine can make your bones weaker than normal. Vitamin D helps your body to take in calcium. So it is a good idea to take vitamin D as well.

Some liver conditions make it hard for you to digest fat in your food. This can make it hard for your body to take in vitamins A, D, E and K. These are called “fat soluble vitamins”. They are usually taken in by your body along with fat in your food.

If this problem goes on for a long time you might need supplements. But it is important to talk to your medical team about this. Taking too much of these vitamins can be dangerous. Too much vitamin A can damage your liver.

If you cannot digest fat then vitamin pills you can buy in shops and pharmacies might not work. They often rely on fat helping you to take in the vitamins. And they might not have the right amount of the vitamin for you. Talk to your medical team about which supplements might help, how much you need, and how to take them.

Some types of liver disease can make it hard for you to eat enough. This could be because you are not able to absorb the fat in your diet. Or it could be that your symptoms make it hard to eat. You can find out more about this on our coping with eating difficulties page here.

If you have a liver condition. Always check with your doctor or registered dietitian before taking any kind of supplement. If your condition makes it hard for you to digest fat then you might be given a food supplement to make sure you are getting enough energy and protein. Always take the supplement you have been given as advised.

Protein supplements

If you want to try a protein supplement, choose a whey protein isolate from a well-known reputable brand. This is especially important if you have a liver condition.

Supplements prescribed by your medical team or dietitian are carefully checked for quality and safety. Not all over the counter protein and sports supplements are checked in this way. This means that what the label says may not be exactly what is in the product. They can contain large amounts of substances that are dangerous for people with a liver condition.

Creatine

Currently there is no good evidence that creatine supplements will help people with a liver condition. There is a risk that side effects from taking creatine could make a liver condition worse.

If your liver is healthy then it should be safe to take creatine supplements. There is evidence that they can help with strength and exercise. But they can have side effects. The main side effect is water retention. So it is particularly risky for people with decompensated cirrhosis who may already have problems with water retention.

Anabolic substances

Do not use anabolic substances such as steroids for sports or to change how you look. These have been linked to a rare type of liver cancer in men. You can find out more about this here.

If you have a liver condition it is important to always talk to your doctor before taking any kind of herbal supplement or medicine. Your liver processes supplements and medicines, so they can add extra stress to your liver.

Some supplements can cause damage to your liver. You are more at risk if you already have a liver condition. You can find out more about drug induced liver injury here .

Weight loss supplements can contain herbs that can damage your liver.

Green tea extract tablets and capsules can cause problems for some people. But drinking normal amounts of green tea is safe.

You can find out more about herbal medicines, including milk thistle, here.