Found this article by accident today. It's about how to take a break from suppliments, which to take continuously, how long to stop for... Q. I read in one of your web pages that you should take a break from supplements, why is that? Q. Another reader asks: I find that Tongkat ali worked great for a while for libido, but then as I kept taking it, it didn't seem to work as well. Do I need to take a break? As a rule, I recommend taking a break from taking supplements. Here are my reasons. Note: The dosage makes a huge difference in how often to take breaks. If your dosage is very low, you can take supplements for prolonged periods with hardly any breaks. If the dosage is high, you would need to take more frequent breaks. !. Certain fat soluble supplements, for instance Vitamin E, can accumulate in tissues such as fat cells. Some accumulate without harm -- such as beta-carotene leading to orange colored palms (carotenemia) -- but others may continue accumulating and potentially cause harm. 2. Overstimulation can occur. For instance, SAM-e can continue building up in the body and cause restlessness, insomnia and irritability if a high dose is taken over several days or weeks. Many herbs, hormones and supplements can have a stimulatory nature. Some of these include acetyl-l-carnitine, CoQ10, DHEA, DMAE, ginseng, pregnenolone, rhodiola, St. John's wort, tongkat ali, trimethylglycine and tyrosine. Taking too many in too high doses can potentially cause heart rhythm irregularities, restlessness, anxiety, and shallow sleep. 4. We just don't know enough about the long term effects of many supplements and herbs if taken daily for periods of months or years. 5. Some of the supplements may interact with the medicines you may be taking or interact with over the counter drugs or even interact with other supplements. 6. Some herbs and supplements may be beneficial to the immune system in the short term, but when taken daily for many months may potentially be counterproductive. For instance echinacea is helpful in stimulating the immune system. If taken daily for several months or years, it is possible that in rare cases it may initiate an autoimmune condition. 7. Long term, high dose, daily use of hormones -- such as DHEA and pregnenolone -- may potentially stimulate tumor growth. Taking "hormone holidays" is likely to significantly reduce the risk. 8. Tolerance can develop. For instance, melatonin and tryptophan may not work as well for sleep if taken every night and you may need a higher dose for the same effect. Certain libido herbs may work by stimulating testosterone release or release of other substances in the brain and body and the body may need a break for a few days to replenish these substances so that the herbs can be effective again. Another form of tolerance is that you may get used to the feelings that the supplements provide and not realize how well you are feeling with them until you take a break for a few days. 9. Certain herbs and supplements may influence the endocrine system in ways that we do not yet fully understand. These may be beneficial or harmful. We just don't know enough about them yet. 10. There may be impurities in the products or the binders and fillers that could be tolerated by the liver or other organs if consumed occasionally, but toxic if consumed daily for prolonged periods. A rough guideline regarding breaks: There are no clear and exact ways to take breaks. Some people like to use a supplement every other day or 2 days on, 2 days off, 5 days on and off on the weekends or a week to ten days off each month. Each person is unique and has different needs, so no blanket statements can be made that would apply to everyone. However, I can give some guidelines on which herbs and supplements can be safely taken with few breaks and which supplements are best taken infrequently. These guidelines only apply to supplements that are being taken for health enhancement purposes and do not apply for supplements taken to treat a particular health condition while under medical supervision. Please note that these are my opinions, other doctors or nutrition experts may have completely different viewpoints. Supplements that can be taken almost every day The B vitamins (less than 50 mg daily of B1, B2, B6), Vitamin C (less than 1,000 mg), Vitamin E (less than 200 units a day), Vitamin D (less than 600 units), Vitamin A (less than 15,000 units); most minerals such as calcium and magnesium; carotenoids, flavonoids, fish oils, green tea, probiotics, psyllium, stevia; herbs used as spices such as basil, curcumin, fennel, ginger; most herbs and supplements used for joint health such as glucosamine and chondroitin; most herbs used for prostate health such as saw palmetto and pygeum; most herbs used for menopause support such as black cohosh, chaste berry and red clover. Products from Physician Formulas that fall into this category include Prostate Power Rx and Joint Power Rx. Supplements that should have more breaks. For instance taking off 2 to 4 days a week or at least a week to 10 days off each month: 5-HTP, acetyl-l-carnitine, arginine, ashwagandha, bacopa, carnitine, choline, CoQ10, creatine, cordyceps, damiana, deer antler velvet, galantamine, ginkgo biloba, ginseng, huperzine, horny goat weed, hyssop, licorice, maca, melatonin, milk thistle, mucuna pruriens, reishi, rhodiola, St. John's wort, tribulus, tryptophan, valerian, vinpocetine and herbs that influence the immune system (such as echinacea, elderberry, andrographis, astragalus); Products by Physician Formulas that fall into this category include Passion Rx and Mind Power Rx. Supplements to be used cautiously or sparingly Hormones such as DHEA and pregnenolone (take no more than 5 or 10 mg); kava (until we learn more), Yohimbe (has many side effects, particularly on high doses). Others There are some herbs and nutrients that I have not mentioned above mostly since I don't know much about their long term use. These include AHCC, beta-glucan, graviola, Lyprinol, mangosteen, nattokinase, and serrapeptase..