Supplements to Avoid While on PrEP and Doxycycline (and How to Take PrEP & Doxycycline Safely)
Introduction
Something I love about gay culture is it seems we are WAY more conscious about staying disease free than when I was straight. Taking PrEP to avoid HIV and doxycycline after hookups to avoid chlamydia, syphilis, and gonorrhea are the norm. Few men know that if you are looking to change your body and are taking supplements, when you choose take the medications matters to make the medications effective.
In this post, we’ll cover the supplements to avoid while on PrEP and Doxycycline and share how to take them safely so your protection stays strong. Before we dive into the details, here's the bottom line up front:
It's always better to take your medicine than to skip them because the timing is imperfect.
I’m not a doctor. I’m sharing this to help you understand basic concepts that confused me as I was learning about sexual health as a gay man, but it’s for education only. Always check with a healthcare provider before making changes to your routine.
What Supplements Interfere With PrEP and Doxycycline
A common question is: can supplements make PrEP less effective? The short answer is yes, but timing solves the problem. The analogy below will teach you what happens when certain supplements are combined with PrEP and Doxycycline. Think of your body like a club.
The medicine (Doxy or PrEP) are the guest.
Being absorbed into the bloodstream is getting inside the club.
The liver and intestines are the security team.
If you take certain supplements close to your medication, things get complicated:
Does calcium, zinc, magnesium, or iron make my PrEP or Doxycycline less effective if taken at the same time? Yes, they bind to the medication and reduce absorption.
Using our analogy, as the guest (your Doxy or PrEP) is in line for the club (being absorbed into the bloodstream), a hot guy comes up and asks them back to their place. Calcium, zinc, magnesium, and iron all, are too hot to ignore. The compound that these minerals make when combined with the Doxy can't be absorbed by the body.
Can Psyllium Husk and fiber interfere with PrEP or Doxycycline? Yes, psyllium husk can form a gel that slows the absorption of the medication.
The very thing that makes insoluble fiber amazing works against us here. When insoluble fiber like psyllium husk is combined with water, it works by forming a gel-like substance that softens what's in the intestines making it more passable. Basically, as the guests (your Doxy or PrEP) come in they get stuck in a line that moves super slow. It makes it so that they may never reach the door (absorbed into the bloodstream).
Can activated charcoal interfere with PrEP or Doxycycline? Yes. It will actually absorb the medication itself before your body does.
To stay as safe as possible you want to avoid taking activated charcoal or products that contain it like Gas-X along with your medication. Using the analogy, when your guests (your Doxy or PrEP) come into the line, imagine a van pulling up and kidnapping them out of the line.
Does St. John's Wort make my PrEP or Doxycycline less effective? Yes. It causes whats called enzyme induction to occur with two important systems in your gut and liver (CYP3A4 and P-glycoprotein, or P-gp for short).
Enzyme induction causes the medication to go through your system faster than it should before it can be absorbed, making it less effective. It's like a pickpocket that shows up. He is friendly and tells the people about a VIP line that will get them to the front faster. Only problem is he took the guest's wallets while escorting them so when they get to the front they are turned away.
Does Goldenseal and high doses of turmeric interfere with PrEP or Doxycycline. Yes. They slow down our two enzymes in the intestines.
This causes the medication to be in your system longer than it should, potentially creating a toxic environment for the body. This also can increase the side effects of the drug, especially if you are sensitive to the medication. It's like when a club hits it's maximum allowable people due to the fire code. This time instead of it being because the event good, it's because our supplements won't let them leave. It creates a danger for everyone.
In most cases, the result is some or a lot of the medication is prematurely processed before it has a chance to build up to levels high enough to protect you. Some of it will still get in, but not as much as it should.
How Should I Time Supplements with PrEP and Doxycycline?
Each supplement has a window of time you can take it apart from the Doxy and PrEP to eliminate the concern. This being said, I tend to try to make my advice as simplistic as possible.
How should I time supplements with PrEP and Doxycycline? I recommend taking medication in the morning and supplements in the evening or vice-versa to keep things simple. Always separate them by at least 4–6 hours for best absorption.
Also, as a reminder: if you ever get to the end of the day and have not taken your medication, take it. It's better for you to have a lower amount than none at all.
What Supplements Are Safe To Take With PrEP & Doxycycline?
Here are supplements that are safe to take with Doxycycline and PrEP. The following will not impact your medication in the slightest:
The Big 3 (Protein, Creatine, & Caffeine/Pre-workouts).
Vitamin D
Fish Oil / Omega-3s
B-Complex
Probiotics
Want to Learn More?
If you would like to learn more about this for free I made the Gay Guy's Guide to Supplements and a free training video to assist you: https://b.link/gggsfreetraining
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