Eli5: Why does taking Multivitamins on an empty stomach cause nausea?

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I know that it’s recommended to take vitamins with food, but why does taking a vitamin first thing in the morning without food cause stomach cramps or nausea?

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Like the other poster said, most of the pill you take is actually indigestible filler material. In general for pills you need that to make sure all those vitamins are packaged together in a nice small capsule, don’t break down and become useless before you even take them, and actually make it the whole way into your body to get ingested. But often that filler will interact with the lining of your stomach, so you’re feeling that. If you have a bunch of food in your stomach being digested it will pretty much block the filler from touching your stomach lining (think about how much material there is in a piece of toast vs a single pill for example).

When you have food in your stomach, it will block some of the stuff in the pill from being absorbed. There’s a sort of balancing act with different medications to ensure your body will actually absorb enough of the med to do what it needs to – some medications they tell you to take on an empty stomach because food will block too much, while others taken over long term can actually seriously damage your stomach lining or digestive system so they have to be taken with food. In the case of multivitamins, they just put more than you need of the vitamins you might not be getting from your diet (or that are blocked more by food) – for example mine has 250% daily value of vitamin B12 – so that you can take it with food and be sure enough is absorbed.

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