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Supplements for Shift Workers

The world of supplements is loud and confusing. There’s a lot of information out there, but is it trustworthy? And what are the unique supplement needs of shift workers?

This information is intended for general educational purposes only and should not be taken as personalized health advice. It should not replace visiting your health professional.

 

During my years as a medical student and resident, I worked my fair share of 24-hour shifts at the hospital. I mostly grabbed food on the run from the cafeteria and survived on coffee and determination. Nutrition was an afterthought, and I definitely wasn’t getting a lot of natural light or fresh air. Taking supplements wasn’t really on my radar.

Today, online media is saturated with vitamins, supplements, gummies, shakes—you name it— promising to make you look younger and feel more vital. Is there any weight to these claims? Would I have benefited from any of these supplements while working long, difficult shifts? Looking back—and knowing what I do now—here’s what I would want my younger self to know.

Do shift workers need supplements?

Supplements and vitamins aren’t substitutes for a balanced diet or adequate sleep. They can, however, in certain circumstances, fill some of the nutritional deficiencies exacerbated by a shifty schedule.

First off, if you’re having new or unusual symptoms since starting night-shift work, start with a visit to your healthcare provider. They may choose to run some basic blood work to identify things like anemia, or vitamin D or B12 deficiencies. If able, consider also speaking to a registered dietician for information about tailoring your foods and nutrients to your unique needs.

Second, it’s vital to keep in mind that, while supplements are regulated, they are not held to the same rigorous standards as prescription medications. Additionally, many manufacturers do not comply with established standards. Companies often make unsubstantiated claims about the benefits of their products, pay social media influencers to vouch for them, and misrepresent ingredients on their labels. It’s a powerful, multi-billion-dollar industry that may put profits before consumer needs.

All that to say—supplements may play a role in maintaining the health of some shift workers. But before you shell out big bucks and stock your medicine cabinet, let’s dive into some popular supplements to review their potential benefits and why you may (or may not!) need them.

Let’s look at the evidence for some supplements

Omega-3 fatty acids

Omega-3 fatty acids are essential fatty acids (meaning our bodies cannot make them). They are necessary for our metabolism, brain function, and the structural integrity of our cell membranes. They are also crucial for babies in the womb. Omega-3s primarily come from fatty fish and some plants.

Studies have shown omega-3 fatty acids may:

  • Lower blood pressure
  • Lower triglyceride levels
  • Improve heart function
 

Sounds great, right? Well, it’s important to be specific here. Major studies of omega-3s and heart health (including heart attack, stroke, and heart-related death) generally found that prescription-strength omega-3s can be helpful for people with certain types of heart disease. People with heart disease or who are at risk of heart disease should speak with their doctor about whether they should receive a prescription-strength omega-3 fatty acid.

There are plenty of other studies and claims about omega-3s. They are often touted as a “cure-all” for a variety of ailments and conditions, and they are one of (if not) the most popular supplements taken.

Outside of the possible cardiovascular benefits, however, there is no conclusive scientific evidence that backs up these claims. In other words, some studies will show a benefit, while an equal number of other studies will not. Omega-3s are currently being researched for cancer, dementia, macular degeneration, dry eye disease, rheumatoid arthritis, depression, inflammatory bowel disease, ADHD, allergies, and cystic fibrosis, so more information may be available in the future.

Do shift workers need omega-3 fatty acid supplements? For the most part, no. We need omega-3s from our diets, not from supplements. At this time, major bodies that specialize in heart disease DO NOT recommend the generalized use of omega-3s. For example, the Canadian Cardiovascular Society advises people not to take over-the-counter omega-3s.

Food sources of omega-3

From Dietitians of Canada:

  • Aim for 1–2 servings of fish per week to meet your omega-3 needs
  • The best sources of omega-3s are fatty fish (salmon, tuna, herring, sardines, anchovies, trout, and mackerel)
  • If you don’t eat fish, some foods are fortified with omega-3s (like eggs and milk)
  • Omega-3s are also found in some plants (flaxseed, walnuts, soy products, kelp, and seaweed)

 

Vitamin B12 and other B vitamins

B vitamins play countless roles in our bodies. From nerve signalling to energy transfer to metabolism to immune function, they really do it all. In particular, B9 and B12 help form red blood cells, white blood cells, and platelets.

Deficiencies (low levels) of vitamins B1, B2, B3, B5, and B6 are more common in people living in low- and middle-income countries. In high-income countries, low levels often stem from conditions where people are not properly able to absorb nutrients (such as alcohol use disorder or after gastric bypass). If this applies to you, please speak to your health care team.

Deficiencies of folate (B9) and cobalamin (B12) are more common. B9 is found in plant sources, and B12 generally comes from animal products. Diets low or absent in animal products (i.e., veganism) may lead to B12 deficiency. Low B12 can leave you feeling tired and worn down, and in severe cases, it can cause numbness in the limbs, trouble walking, or mental health problems, so it’s important to supplement in this case.

Do shift workers need B vitamin supplements? Some do, yes, but not necessarily due to their shifty schedule. Vegetarians who rarely eat animal products and vegans should take B12 regularly to prevent deficiency (either through supplements or fortified foods, like yeast or cereals). Pregnant people (and people who may become pregnant) should take a folic acid supplement. People with health conditions that reduce their absorption of nutrients should talk to their health care provider or dietitian about supplements for B vitamins and others.

Glutathione

Glutathione is an antioxidant produced naturally in the body. It plays a role in many processes, including neutralizing free radicals and protecting cells from damage by toxins. Glutathione has been studied as a supplement to improve athletic performance; however, it was not shown to be beneficial in this regard. Glutathione may also have side effects of stomach cramps, bloating, allergic reactions, and low zinc levels. Inhaled glutathione can trigger asthma, and injected glutathione can be toxic to the body.

Do shift workers need glutathione supplements? No. But they should try to eat foods that contain glutathione, such as cruciferous vegetables, onion, garlic, eggs, nuts, legumes, and lean animal protein for their all-around benefits.

Magnesium

Magnesium helps us produce energy and affects many of the body’s systems. It helps us make DNA, fats, and proteins. It helps make insulin and helps our bodies use blood sugar. Critically, it is involved in muscle relaxation.

Low levels of magnesium in the body are sometimes seen in patients who are in the hospital or intensive care unit. This can show up as muscle shaking, weakness, and confusion. It can also affect the heartbeat and lower the amount of other vitamins and minerals in the body.

Health benefits of magnesium include possibly lowering blood pressure and increasing bone density. On the other hand, magnesium has not been shown to help with diabetes. Also, be careful: magnesium can interact with many medications, including bisphosphonates (for osteoporosis), antibiotics (tetracyclines, fluoroquinolones), diuretics (furosemide, hydrochlorothiazide), and proton pump inhibitors (a.k.a. acid reducers, esomeprazole, lansoprazole).

Do shift workers need magnesium supplements? Most of the time, no. However, certain people might benefit from them. For example, magnesium might be helpful if you are experiencing migraine headaches.

What about mental health and magnesium?

Studies have shown that people with depression often have low magnesium levels. So does this mean a magnesium supplement will help? Not necessarily.

Studies of people with depression who were treated with magnesium have shown inconsistent results. More research seems to be needed here. If you are struggling with your mental health, talk to your health care provider about magnesium to see whether it’s worth a shot.

What about sleep and magnesium?

A 2023 systematic review examined this link. Observational studies have found some links between magnesium and sleep, while randomized control trials have found inconsistent evidence. At this time, we are still lacking high-quality evidence to recommend magnesium for sleep.

Food sources of magnesium

Remember: all people need magnesium, just not from supplements. Dietary intake is the cheapest, safest, and easiest way to maintain normal magnesium levels. An older 2005–2006 study found that many Americans don’t consume enough magnesium-containing foods. Magnesium comes from a variety of plant and animal sources, so it’s easy to pick your favourite:

  • Green, leafy vegetables
  • Fish
  • Legumes
  • Whole grains

 

Probiotics

Probiotics, also known as “good bacteria,” are naturally found in the body and help with digestion, allergies, infections, and more. In supplement form, “probiotics” refers to specific, safe strains of bacteria that are thought to confer some benefit to the body. Prebiotics are another related supplement, which contains the “food” (starches and fibres) that probiotics like to eat.

Probiotics are found in foods like yoghurt, cheese, breast milk, and fermented foods (miso, tempeh, sourdough, beer, bread, kimchi, olives, pickles, and kefir). While probiotics are essential to our bodies, there isn’t great evidence that taking a pre- or probiotic supplement on a regular basis will benefit most people. There may be certain medical conditions where probiotics can be helpful, like H. pylori infection or antibiotic-associated diarrhea, but these are often on a case-by-case basis.

Do shift workers need probiotic supplements? Generally, no. While we know that the bacteria of the gut seem to be integral to many systems in our bodies (including our digestive system, immune function, and mental health), studies of probiotic supplements tend to show mixed results or no benefits. Research is still underway in this field; however, so stay tuned!

Vitamin D

Vitamin D is an essential vitamin and micronutrient that keeps bones and teeth strong and regulates levels of calcium and phosphorus in our bodies. Other effects of vitamin D are still being studied, but it may play a role in our immune, cardiovascular, muscular, metabolic, and psychiatric systems.

Vitamin D is more than just a vitamin—it’s actually a hormone that is made by the body when it’s exposed to sunlight. The amount of vitamin D our bodies make, however, is generally not enough, and we require additional vitamin D from our diets or supplements.

Do shift workers need vitamin D supplements? Yes, many do. Vitamin D is important for many of our bodies’ functions, and it may play a role in diverse functions like sleep and chronic pain. Research is still being done on all of its effects, but we do know that many people who work nights are exposed to less sunlight than those who work a 9–5. Low sun exposure puts people at risk for low vitamin D levels.

Is my vitamin D low? How much vitamin D should I take?

It’s actually a little tricky. There are many opinions in the medical community about what defines low vitamin D and the best supplement dose. The numbers will generally depend on where you live. For example, Health Canada and Public Health Ontario recommend:

  • People aged 9–70 should get a total of 600 IU of vitamin D per day, ideally from food sources (about 500 mL of vitamin D-fortified milk or plant milk)
  • If a person requires a supplement, they should take 200 IU per day
  • People over age 50, regardless of vitamin D level, should take a daily supplement of 400 IU
 

Certain people are more at risk of vitamin D deficiency. Risks include:

  • Increased skin pigmentation
  • Lack of sun exposure
  • Chronic kidney disease
  • Intestinal conditions (e.g., inflammatory bowel disease)
  • Prolonged stay in the hospital
  • Medications that interfere with vitamin D (e.g., corticosteroids, phenytoin)
 

If you are concerned about your vitamin D level, it’s best to discuss it with a health care provider first. (In some places, vitamin D testing is not paid for by the government. That’s because widespread screening and supplementation programs did not show all-cause mortality benefits.)

Food sources of vitamin D

Here are some vitamin D-rich foods recommended by Health Canada:

  • Fatty fish
  • Egg yolk
  • Fortified cow’s milk
  • Fortified plant-based milk
  • Fortified cereal
  • Fortified orange juice

The good news is, there are some easy ways to get extra vitamin D without going to the doctor or taking a supplement. You only need brief periods of sun exposure (5–10 minutes twice a week) without sunscreen for your skin to make a sufficient amount of vitamin D. On your off days, try to spend some time in the sunshine. Depending on what time you work, you can also try to get some sun before your shift begins. For prolonged or regular sun exposure, however, you should wear sunscreen and/or cover your skin.

Iron

Iron is a mineral (also called a trace element) that is essential for your red blood cells, which carry oxygen throughout the body. Iron is found in hemoglobin, the substance in red blood cells that binds to oxygen. Without adequate iron, your body can’t produce enough hemoglobin for red blood cells. This can lead to iron deficiency anemia, which can cause fatigue, restless legs, headaches, shortness of breath, weakness, and ice cravings. These symptoms may come on slowly and not be noticed at first.

Anemia can often be due to a heavy menstrual cycle or period. Other causes of anemia can include a low-iron diet, pregnancy, H. pylori infection, celiac disease, and bariatric surgery. It is also possible to have low iron without yet being anemic. The diagnosis of iron deficiency anemia should be made with your health care provider. They may do blood tests to confirm the diagnosis and look for other issues. It may be important for them to make sure that you don’t have another source of bleeding (other than a menstrual period, like bleeding from the stomach or bowel).

Iron supplements are generally oral (pills, capsules, tablets), but iron can also be given intravenously. The best iron supplement is one you can take regularly. Iron often has side effects of nausea, constipation, bloating, and diarrhea. To ease these symptoms, some people take their iron every other day on an empty stomach. Liquid forms are easier to take but can be more expensive.

Do shift workers need iron supplements? Some do. However, it is more likely to be based on that person’s individual needs rather than the fact that they work nights.

The most common source of anemia for shift workers is—you guessed it—a heavy menstrual cycle. (Note, a non-heavy or “normal” menstrual cycle does not usually lead to anemia unless it is paired with a low-iron diet.)

Food sources of iron

Here is how Health Canada recommends getting iron from the diet: 

  • Heme iron is found in meat, poultry, and fish. This type of iron is easier to absorb.
  • Non-heme iron is found in fruits and vegetables and iron-fortified products (like cereals and bread). The body has a slightly harder time absorbing non-heme iron. 

 

Vitamin C

Vitamin C plays a vital role in the body. It helps to absorb iron, heal wounds, and protect against infection. Vitamin C also aids in the growth and repair of tissues in all parts of the body and is essential for healthy bones, gums, teeth, and blood vessels. (Scurvy comes from inadequate  vitamin C.) Additionally, vitamin C is known to have powerful antioxidant properties that can help neutralize damaging free radicals.

Do shift workers need vitamin C supplements? No. For this one, skip the supplement: Add citrus fruits, tomatoes, peppers, and leafy greens to your diet to get that extra vitamin C goodness. (Please note: people with calcium oxalate kidney stones should talk to their doctor before taking vitamin C.)

What do scientific studies say about vitamin C and shift work?

Vitamin C is an essential nutrient for all bodies, and it may have a particular use for shift workers. 

A study published in Nature found that night workers are more at risk of oxidative stress damage than their day-working counterparts. This could potentially explain the impact that shift work has on some people’s overall health. Therefore, a diet rich in antioxidant vitamin C could be particularly helpful for shift workers. 

A study from 2019 found that adequate vitamin C levels helped improve concentration, focus, and memory, which are all needed when working long shifts overnight.

A large 2020 review found that vitamin C is likely beneficial for maintaining good sleep health—something that shift workers in particular are aware of.

Experts agree that vitamin C supplementation does not help prevent disease in general, and it also doesn’t help prevent the common cold. That said, there’s no harm in eating a little more of your favourite fresh produce!

 

Multivitamins 

Do shift workers need multivitamins? Probably not. Folks with extremely restricted diets, alcohol use disorder, gastric bypass surgery, or other chronic illness should talk to their health team or registered dietitian to see if multiple vitamin supplements are needed. People on dialysis and total parenteral nutrition may also require multiple vitamin and mineral supplements. Otherwise, studies show that these tend to be a waste of money, and some researchers have found potential harms when studying populations that take multivitamins.

Of course,  people with certain medical conditions that reduce their digestion or absorption of nutrients will have different requirements and should consult with their medical provider and registered dietitian. People who are or may become pregnant will also have unique vitamin needs and should follow their country’s recommendations.

Getting a variety of micronutrients is essential for our bodies. But for whatever reason, supplements just don’t seem to stack up to food in most cases. Check out our pages on meal planning and night-shift snacks for more ideas if you are struggling with food in general! 

Last updated: 2024-01-09

Picture of Emma Farley, MD CCFP

Emma Farley, MD CCFP

On her journey to become a physician, Dr. Emma Farley worked many nights shifts caring for patients while balancing a heavy study workload. As a medical writer and editor at Night Shift Wellness, she creates practical and evidence-based articles for readers.

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