Nutrition at 72: Many Medicines and Food Interactions
By the early seventies many people take five or more medicines a day, and some of them interact with food in ways that are easy to get wrong. Show every medicine and supplement to one doctor or pharmacist, and ask what to eat, avoid or space out.
- Taking several medicines raises the chance that one interacts with food or a supplement.
- Long-term metformin can lower vitamin B12 — ask about testing.
- On warfarin, keep vitamin K foods like palak consistent rather than avoiding them.
- Thyroid tablets work best apart from calcium and iron supplements.
- Never stop or change a medicine because of a diet article — ask first.
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Why this becomes important now
Taking many medicines at once — often called polypharmacy — is common after 70. Each new prescription is reasonable on its own, but together they raise the odds of interactions with each other, with supplements and with food.
This page is general information. Your own medicines, doses and conditions decide what applies, so treat it as a list of questions to ask, not instructions.
Common interactions, in plain language
| Medicine | food or nutrient issue | what to ask |
|---|---|---|
| Metformin (diabetes), long-term | Can lower vitamin B12 | Should my B12 be checked? |
| Warfarin (blood thinner) | Vitamin K in leafy greens affects it | How consistent should my palak and methi be? |
| Levothyroxine (thyroid) | Calcium and iron reduce absorption | How far apart should I take them? |
| Acid-reducing tablets (PPIs), long-term | Can reduce B12 absorption | Do I still need this dose? |
| Some statins | Grapefruit raises blood levels | Does this apply to my statin? |
A long-term study of metformin users in the Diabetes Prevention Program found lower B12 levels with longer use, which is why periodic testing is often recommended. nutrition at 75 covers B12 in older adults.
The warfarin and greens point, properly
People on warfarin are sometimes told to stop eating green leafy vegetables. The usual medical advice is different: keep vitamin K intake consistent from week to week, because the dose is adjusted to your normal diet. A sudden big change in either direction is what causes problems.
Supplements count as medicines here
Calcium, iron, vitamin D, herbal products and fortified foods can all interact. Many people do not mention them because they do not think of them as medicines. Bring everything, including products bought without a prescription, to a medicine review.
nutrition at 51 covers statins in more detail, and signs of vitamin deficiency lists symptoms worth reporting.
Ask for a medicine review
Once a year, or after any hospital stay, ask a doctor or pharmacist to review everything you take together. It is one of the most useful appointments an older adult can have.
Where KABO fits in
This page is about interactions, and a fortified shake is one more product to put on the list for a medicine review, not something to add quietly.
A KABO serving provides 23–25 g of complete plant protein, 26 vitamins and minerals, 4 g of fibre and 8 billion probiotics in about 198 kcal, from 60+ ingredients; it is vegan and lactose-free. Because it is fortified, show the label to your doctor or pharmacist before using it alongside regular medicines, especially warfarin, thyroid tablets or calcium and iron supplements. If you follow a kidney-related diet restriction, check with your nephrologist before adding any protein product, and if you take several medicines, show the label to your doctor or pharmacist first — fortified products can contain vitamin K, which matters on warfarin.
Butter Coffee — All-in-One Nutrition Shake
25 g complete plant protein, 60+ superfoods, 26 vitamins & minerals, probiotics & digestive enzymes — in one 90-second shake.
Read next
- Nutrition at 70: The PROT-AGE Numbers, Meal by Meal
- Nutrition at 74: Constipation, Fibre and Enough Water
- Nutrition at 71: Falls, Vitamin D and Why Exercise Wins
- Nutrition at 73: Thirst Fades, So Drink to a Schedule
- Complete Nutrition India: Balanced Diet & Wholesome Food with KABO
- How Many Calories Are in an All-in-One Nutrition Shake?
Frequently asked questions
Does metformin cause vitamin B12 deficiency?
Long-term metformin use is associated with lower vitamin B12 levels, as shown in follow-up of the Diabetes Prevention Program. Many doctors recommend checking B12 periodically in people who have taken metformin for years. Do not stop metformin without medical advice.
Can I eat palak if I take warfarin?
Usually yes. The common advice is to keep vitamin K foods such as palak and methi consistent from week to week rather than avoiding them, because the warfarin dose is matched to your usual diet. Follow the guidance of the doctor managing your warfarin.
Should thyroid tablets be taken separately from calcium?
Calcium and iron supplements can reduce levothyroxine absorption, so they are often taken several hours apart. Ask your doctor or pharmacist for the spacing that suits your routine.
What is polypharmacy?
It means taking many medicines at the same time, commonly five or more. It is frequent in older adults and increases the chance of interactions between medicines, supplements and food.
Who should check my medicine and food interactions?
A doctor or pharmacist who can see every medicine and supplement you take. An annual medicine review, and one after any hospital stay, is a good routine.
Nutrition by age
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Sources
- Aroda VR et al., "Long-term metformin use and vitamin B12 deficiency in the Diabetes Prevention Program Outcomes Study", Journal of Clinical Endocrinology & Metabolism, 2016;101(4):1754-1761.
- ICMR-NIN, Nutrient Requirements for Indians (RDA 2020) and Dietary Guidelines for Indians, 2024. nin.res.in
- Volkert D et al., "ESPEN guideline on clinical nutrition and hydration in geriatrics", Clinical Nutrition, 2019;38(1):10-47.
- World Health Organization, Healthy diet fact sheet. who.int