What Supplements Should I Take with Prednisone to Support My Health?

October 7, 2025 •

4 min read

In the United States, about 6.8% of the adult population uses oral corticosteroids like prednisone annually. If you've been prescribed this medication, a common question is, 'What supplements should I take with prednisone?' to help counter its nutritional side effects.

Quick Summary

Taking prednisone can interfere with nutrient absorption, making supplementation necessary for some. Key supplements like calcium and vitamin D are crucial for bone health, while others may help manage specific side effects.

Key Points

Doctor First: Always consult your healthcare provider before starting any supplements while on prednisone.
Bone Health is Priority: Calcium and Vitamin D are the most critical supplements to protect against prednisone-induced osteoporosis.
Mind Your Nutrients: Prednisone can deplete key nutrients like potassium, calcium, vitamin D, and protein.
Diet is Foundational: A low-sodium, low-sugar, high-protein diet helps manage side effects like weight gain, fluid retention, and blood sugar changes.
Watch for Interactions: Avoid immune-boosting herbs like echinacea and be cautious with substances like licorice and grapefruit.
Monitor Potassium: Focus on potassium-rich foods like bananas and spinach to counteract potential depletion.

Prednisone is a powerful corticosteroid used to treat a wide range of inflammatory conditions. While effective, it can interfere with how your body absorbs and uses essential nutrients, leading to potential side effects. Strategic supplementation, alongside a healthy diet, can help mitigate these effects. However, it is crucial to consult with your healthcare provider before starting any new supplement regimen.

Why Supplementation is Important on Prednisone

Long-term corticosteroid therapy can lead to the depletion of several key nutrients. The primary concerns are the drug's impact on bone density, electrolyte balance, blood sugar, and protein breakdown. Prednisone decreases the body's ability to absorb calcium and interferes with vitamin D metabolism, which is critical for bone health and increases the risk of osteoporosis. It can also cause the body to excrete potassium, potentially leading to low levels, and may affect levels of vitamins C, B6, zinc, and magnesium.

Core Supplements to Discuss with Your Doctor

These supplements are most frequently recommended for individuals on long-term prednisone therapy.

Calcium & Vitamin D: The Bone Protection Duo

Long-term prednisone use is a well-known risk factor for osteoporosis, a condition that makes bones weak and prone to fracture. The medication both reduces calcium absorption from your gut and increases its excretion through your kidneys.

Calcium: To counteract this, a higher intake is necessary. While dietary sources like dairy products, fortified juices, and leafy greens are beneficial, supplements are often required to meet calcium needs.
Vitamin D: This vitamin is essential for your body to absorb calcium. Prednisone can interfere with vitamin D metabolism. Adequate vitamin D intake is often recommended. Sunlight exposure helps your body produce vitamin D, but supplementation is frequently needed to ensure sufficient levels.

Potassium: Maintaining Electrolyte Balance

Prednisone can cause your body to lose potassium, which can lead to fluid retention and affect muscle and nerve function. Rather than immediately turning to supplements, your doctor will likely recommend increasing your intake of potassium-rich foods. Excellent sources include:

Bananas
Baked potatoes
Spinach
Apricots and prunes
Oranges and grapefruit
Yogurt and milk

Potassium supplements should only be taken under strict medical supervision, as incorrect use can be dangerous.

Other Potential Supplements

Depending on your specific situation, other supplements might be considered.

Protein: Prednisone can increase the breakdown of protein in the body. Ensuring a high-protein diet with lean meats, fish, eggs, and beans is important to maintain muscle mass.
Melatonin: Steroids can cause insomnia. Some preliminary studies suggest that corticosteroids may suppress the body's natural melatonin production. If you experience sleep disturbances, discuss the possibility of taking melatonin with your doctor.
Magnesium & Zinc: Corticosteroids may increase the loss of these minerals through urine. Maintaining adequate levels is important for overall health, often achievable through a balanced diet including nuts, seeds, and leafy greens.

Supplement & Diet Comparison Table


Nutrient/Supplement	Reason for Consideration with Prednisone	Key Dietary Sources
Calcium	Prevents bone loss ( osteoporosis ) by countering decreased absorption.	Milk, yogurt, cheese, fortified juices, broccoli, kale, sardines.
Vitamin D	Crucial for calcium absorption and bone health.	Salmon, tuna, egg yolks, mushrooms, fortified milk.
Potassium	Counteracts potassium loss, which can cause fluid retention.	Bananas, oranges, baked potatoes, spinach, apricots, yogurt.
Protein	Offsets increased protein breakdown and muscle loss.	Lean meats, poultry, fish, eggs, beans, tofu, nuts.

Supplements and Foods to Approach with Caution

Certain substances can interact with prednisone or worsen its side effects.

Sodium: Prednisone causes the body to retain sodium and fluid, which can lead to swelling and high blood pressure. It is essential to follow a low-sodium diet and avoid highly processed and salty foods.
Immune-Boosting Herbs: Supplements like echinacea that claim to 'boost' the immune system may counteract the immunosuppressive effect of prednisone and should be avoided.
Licorice: Licorice can slow the elimination of prednisone, potentially increasing its effects and side effects.
Grapefruit: Grapefruit and its juice can interfere with the enzymes that break down prednisone, increasing its concentration in the blood.

Conclusion: A Collaborative Approach to Your Health

While taking prednisone, focusing on a nutrient-dense diet that is low in sodium, low in simple sugars, and high in protein, calcium, and potassium is your first line of defense. Supplementation, particularly with calcium and vitamin D, is a key strategy to protect against long-term side effects like osteoporosis.

Crucially, never add or remove a supplement without first consulting your healthcare provider. They can assess your individual needs based on your medication plan and overall health to create a safe and effective plan for you.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before making any decisions about your health or treatment.

Authoritative Link: Prednisone and other corticosteroids - Mayo Clinic

Frequently Asked Questions

For long-term prednisone therapy, supplementation with calcium and vitamin D is almost universally recommended by healthcare professionals to prevent bone loss and osteoporosis. Your doctor can recommend a suitable approach for you.

Adequate daily intake of vitamin D is often recommended for patients on long-term corticosteroid therapy to aid in calcium absorption and protect bones. Always confirm the specific amount with your doctor.

While it's possible, it can be challenging to meet calcium needs while on prednisone through diet alone. While calcium-rich foods like dairy and leafy greens are encouraged, a supplement is often needed to consistently reach recommended levels.

Prednisone can increase potassium loss. Symptoms of low potassium (hypokalemia) can include muscle cramps or weakness, constipation, and abnormal heart rhythms. If you experience these, contact your doctor.

While the evidence is not strong, some corticosteroids have been shown to deplete vitamins B6 and B12, which can affect mood. Discussing this with your doctor is the best course of action, as mood changes are a known side effect of the medication itself.

You should avoid any herbal supplements that claim to 'boost' the immune system, such as echinacea, as they can work against the intended effect of prednisone. Also, be cautious with licorice and grapefruit, which can alter the drug's concentration in your body.

Generally, a standard multivitamin is often considered safe, but you should discuss it with your doctor. Be aware that calcium supplements can interfere with iron absorption, so it's often recommended to take your multivitamin (which may contain iron) and your calcium supplement at different times.