Is changing the timing of Tendocare forte (vitamin and mineral supplement) to after a mid-day meal and adding 2000 IU vitamin D supplementation at night causing my constipation?

Vitamin Supplementation and Constipation

Yes, changing the timing of Tendocare forte to midday and adding vitamin D supplementation at night could be contributing to your constipation, particularly due to the calcium content in Tendocare forte.

Why This May Be Causing Constipation

Calcium Supplements and Constipation

• Calcium supplements, particularly calcium carbonate formulations often found in multivitamin and mineral supplements like Tendocare forte, are known to cause constipation in some individuals 1
• Taking calcium supplements with meals (as you're now doing with your midday dose) increases absorption but may also concentrate the constipating effects

Vitamin D Supplementation

• While vitamin D supplementation of 2000 IU is generally considered safe and appropriate 2, it can enhance calcium absorption in the intestines
• The combination of increased calcium absorption (due to vitamin D) and the calcium in Tendocare forte may be exacerbating constipation symptoms

Management Recommendations

Timing and Administration

• Consider returning to your previous schedule of taking Tendocare forte at night if you weren't experiencing constipation with that regimen
• If you need to continue the current schedule, ensure adequate hydration throughout the day, especially after taking Tendocare forte

Dietary Modifications

• Increase dietary fiber intake gradually to help counteract constipation
• Ensure adequate fluid intake (at least 8 glasses of water daily)
• Consider adding foods known to have natural laxative effects (prunes, kiwifruit, etc.)

Supplement Adjustments

• If Tendocare forte contains calcium carbonate, consider discussing with your healthcare provider about switching to a formulation with calcium citrate, which is less likely to cause constipation 1
• Maintain your vitamin D supplementation as 2000 IU daily is an appropriate dose for most adults 2, but consider taking it with your largest meal of the day for better absorption

Important Considerations

Monitoring

• If constipation persists despite these changes, consult with your healthcare provider
• Watch for other symptoms such as abdominal pain, bloating, or changes in bowel habits that persist, as these may indicate other underlying issues

Prevention

• Divide calcium doses if you're taking more than 500 mg daily to minimize gastrointestinal side effects 1
• Regular physical activity can help maintain normal bowel function
• Establish a regular toileting routine to help regulate bowel movements

The constipation you're experiencing is likely related to the change in your supplement regimen, particularly the timing of calcium-containing supplements and the addition of vitamin D which enhances calcium absorption. Simple adjustments to your supplement schedule and ensuring adequate hydration and fiber intake should help resolve this issue.