The word is “supplements” and so, by definition, they are obviously not a substitute for a good diet. For some people supplements are actually life-saving. And billions of dollars and untold suffering could be saved if more attention was paid to the disease-prevention and healing properties of dietary supplements.
Who needs dietary supplements? If a person has flawless genes, zero physical complaints, takes no medication and lives on a stress-free, pollutant-free mountain top growing his or her own nutrient-rich organic food, maybe they don’t need supplements. Real humans will almost certainly benefit from them because virtually every study shows that even upper income, well-educated citizens no longer consume crucial nutrients at even the modest levels the government recommends…let alone at optimum levels. That shortfall is due in part to a change in eating habits and in part to depletion of soil minerals that is documented by government studies. Nutrient content is further degraded by genetic engineering of seeds; picking of crops while still green; storage conditions; long haul shipping; processing; cooking, storing leftovers and reheating. Modern life also increases our needs with nutrient-sapping challenges such as chemical toxicity and chronic stress.
Are supplements safe? Yes. Toothpicks may be more dangerous than vitamins and minerals. Of course, you can overdose on vitamins and minerals if you get ridiculous. (Too much water or oxygen are dangerous.) Products made by mainstream companies are typically well-balanced and provide instructions to keep you in the safe zone. Any Adverse Event Reports (AER’s) experienced by consumers must be sent to the Food and Drug Administration (FDA). But those gripes can be anything—even if the smell of an old pill spoiled someone’s appetite. In the case of the rare serious complaint, unfortunately no one verifies that the supplement was more than an innocent bystander—medications or other factors may have been the real cause. The number of complaints is quite small—about one per manufacturer per year. (Surely, corn flakes cereal gets that many.) I am most concerned with supplements imported from Asia because sometimes they are contaminated with medications or heavy metals. Also, I am reluctant to buy from fly by night marketing companies selling brands we’ve never heard of because they don’t have a reputation to protect. Be especially cautious of products with wild claims for sexual enhancement, weight loss or body building.
Are supplements proven to work? They are considered proven to cure deficiency diseases. Beyond that, there is no FDA mechanism for “proving” the efficacy of vitamins, minerals, herbs and other nutrients for the remediation or even prevention of disease. The only reason drug companies spend millions to do the studies required for FDA approval is that they can patent the chemical and get a return on their investment. Nutrients cannot be patented. Even worse, strict rules prevent the manufacturers from even openly discussing studies done on their products. So, supplement manufacturers are not rewarded for investing in research. If they spend the money, others can use the study to sell competing products. In any case, there is such a regulatory bias against supplements that it is virtually impossible to compile enough studies to get approval for even an extremely modest health claim. For example, in spite of a large amount of research, it was many decades before the FDA allowed manufacturers to hint that folic acid might prevent a type of birth defect. (How many children died while the bureaucrats pondered? Is the answer to getting them to respect nutrients to call them “drugs” like they did the mineral magnesium in this journal article? LINK.)
Which nutrients are needed? Aside from monitoring iron levels and the encouraging trend toward checking vitamin D levels, there is typically no testing of nutrient levels in connection with an annual physical. (That may be for the best because most doctors have not been trained to deal with the results.) Nutritionists can order functional nutrient testing which can be very helpful, especially for those with genetic defects in nutrient processing. However, most people can just take a basic supplement program. I think the best results come from getting nutrients in the forms and complexes that are most similar to how they occur in food. The basic plan I recommend covers the most fundamental needs and is balanced to avoid overdoing any one nutrient. It is built on a foundation of multi-purpose supplements that benefit cells and therefore a wide range of organs and systems. As the American diet worsens and toxins or stress increase our need, any nutrient supplement can become a life-saver as is shown in this terrific article by Bill Sardi on zinc.
How much is enough? Guidelines set by the government (RDA’s, DRI’s or whatever they are calling them at the moment) are controversial. They aim mainly to avoid the frank deficiency diseases encountered in the third world—not to achieve optimal function or longevity. Nor do they address the fact that each of us has a unique biochemistry. You may require many times the amount of a vitamin as your neighbor. Our needs also vary over time because of age-related reduced absorption and the demands of stress, medications and toxicity. Typically, people can safely take many times the recommended intake ofvitamins. Some of the vitamins will surely not be used, but it is better to have them and not need them. Minerals can also be consumed in quantities larger than the guidelines suggest, but there isn’t nearly as much latitude—and they should always be kept in balance. In the rare case that someone gets in trouble with nutrients, it is usually because the person over did one nutrient and created an imbalance. Unless your health professional advises differently, use the dose recommended on the bottle. Be sure to read both “serving size” and directions to make sure you take the right number of pills. Here is how nutrients are measured:
Milligram (mg) – most bulky vitamins and minerals are measured this way. 1000 milligrams make a gram.
Microgram (mcg) – 1000 th of a milligram (i.e. 1000 micrograms = 1 milligram). This measure is appropriate for trace minerals like Chromium and Selenium. B12, K2 and Folic acid are typically measured in micrograms. Don’t be fooled by labels that list use micrograms where milligrams would be more appropriate. For example, mass market multivitamins sometimes include Lycopene or Lutein in microgram quantities. That borders on fraudulent since they are only putting in a tiny fraction of what was shown in studies to be useful.
IU – International units – This measure is used for oil-soluble vitamins A, D and E.
Condition-specific supplements. Due to regulations limiting label claims, it is sometimes a little hard to tell what some supplements are actually for even when combinations are formulated to solve specific problems.Common examples are supplements for prostate enlargement, joint pain and memory. They can be quite helpful, but if the basics are given a chance to work their magic repairing cell membranes and fix the problems we’ve created over time with poor nutrition, it may not be necessary to chase problems with separate supplements. If you choose to take several combinations, it is a good idea to add up the minerals in those plus those in your multivitamin/mineral to make sure you aren’t creating an overload or an imbalance.
Interactions and your doctor. It is always smart to make a partner out of your doctor by taking in a list of your supplements. That way any medications that he or she prescribes can be adjusted to allow for the benefits you are getting from your supplements. The most common interaction between drugs and nutrients is that most drugs deplete nutrients. That is one reason for drug side effects. A classic example is that statin-type cholesterol-lowering drugs reduce our levels of crucial CoQ10. Good references for which nutrients might be needed because of a medication are Drug Muggers by pharmacist Suzy Cohen and Supplement Your Prescription by Hyla Cass, MD. Check the package insert on any medication to see if there is any nutrient (or even grapefruit juice or pomegranate juice) that you should avoid. Most integrative medicine doctors encourage patients to keep their supplement program relatively regular and they adjust medication levels around the nutrition. Makes sense to me!
How to take supplements. Supplements are basically concentrated food and therefore are better utilized when the digestive system is up and running. So, except in cases where the package says otherwise, supplements are best taken with meals. For example, Vitamin E, Vitamin D and Co Q10 are oil-soluble nutrients that are best absorbed when taken with a meal containing fat. Vitamin C and the B vitamins flush out of the system quickly and should be taken more than once a day. Probiotics usually should be taken on an empty stomach. However, if you are chewing a soft gel probiotic for help with the stomach, you don’t need to follow that rule.
Storing supplements. Protect your nutrients from heat and light, but you should not need to refrigerate them. To stay regular on a supplement regime, I recommend making up little daily packets. I like to use small soufflé cups sold in restaurant supply houses—two dishes (AM and PM) for each day of the week. I drop the correct number of each supplement into each dish. Then I dump each dish into small zip lock vitamin bag available where you buy your vitamins or in the bead department of a craft store. (Snack size food bags are a little big but also work.)
Where to buy supplements. I recommend buying from a natural foods store that you trust. They will usually check the sources and verify that the manufacturers use the right forms of nutrients and have sophisticated safety practices. You will also get better advice there than from a mass market store. (Please support the folks that give you the information and service!) Always go for quality, because cheap products that don’t get the job done are really just a waste of money. HealthWorksMart.com asks me to review the products that they carry and I approve of that store. (Another reason I trust them is that the owner, Andy Hopkins, is my son.)
Dr. Parris Kidd reviews what constitutes a basic supplement program and how to separate the “wheat from the chaff” in selecting products. LISTEN
Drug Muggers by pharmacist Suzy Cohen
Supplement your Prescription by Hyla Cass, MD
Encyclopedia of Nutritional Supplements by Joseph E. Pizzorno, ND and Michael T. Murray, ND
A-Z Guide to Drug-Herb-Vitamin Interactions by Alan Gaby, MD
Copyright 2014 by Martie Whittekin, CCN