In my last blog post, I gave you my top 5 tips for picking a quality supplement. But that’s really the second part of the equation.
The first part of the decision tree is: Do I need to take a supplement? And if so: What do I need to consider?
I get that there is always talk in the media about the latest and greatest nutrient. And the minute that happens, about a thousand different supplements appear on the market ready to be the silver bullet you’ve been looking for! But alas, you know there is no magic potion for health, and still it’s easy for us to be seduced by the idea of an easy solution.
Don’t get me wrong; I take supplements every day, and I am clear that they are a helpful and sometimes necessary thing. But they cannot make up for a crappy diet; they might not do you any good (resulting in wasted money); and they can cause problems if not taken appropriately.
So, if you aren’t already eating a generally healthy diet, start there! And come back to this blog later.
But if you are already doing a good job with your food intake and you’re still not sure if you need a supplement (or two or more), these are the questions you should ask yourself (or your healthcare practitioner) before beginning a supplementation protocol:
1. Can I get enough of this nutrient, in the right form, from food?
Have you gotten the message yet?! Ha! I know I keep going back to this and I feel like I’m doing you a disservice if I don’t mention again that generally the best place to get the nutrients you need is from food. So, in that spirit, you should first ask yourself if you can get enough of the nutrient you are looking for from food.
And, by the way, this is a different question than “do I want to eat the foods that have this nutrient?” While no single food has a monopoly on a single nutrient, there are groups of foods that, if eliminated, leave us with a hole in our nutrient intake. For example, if you don’t like leafy greens (kale, spinach, collard greens, beet greens, chard, etc.), then you likely aren’t getting enough vitamin K1 in your diet. Sure, you could take a K1 supplement, but then you’d be missing out on the fiber, folate, carotenoids, vitamin C, iron and calcium that are also found in leafy greens. (If you don’t enjoy eating leafy greens, check out my blog post The Secret to Liking Food That’s Good for You.)
By the way, the answer to this question is not always yes. There are some situations where the best form of the nutrient isn’t available in food. When the answer to this question is “no”, it is usually because the nutrient concentration in food is less than you need or you need the active form of the nutrient, which isn’t generally how these are found in nature. I commented a bit about this in part 1.
2. Will taking this supplement address the problem I’m trying to solve without introducing other problems?
In other words, will this supplement do you any good? Because the fact is, you could take a ton of supplements, but they may not help you at all or they might cause other problems. So be sure you know what the problem is you want to solve and that the supplement is at least part of the answer.
Let me give you an example… If you have low iron (whether determined by free levels in your blood, anemia based on red blood cell data, or measured by its storage form ferritin), taking an iron supplement might not resolve the issue. Presuming you are not a vegan and/or pregnant, then you need to consider why the iron from your food isn’t enough to maintain the levels in your body. Here are two possible causes:
- You have an overgrowth of microbes in your small or large intestine (microbes love iron and use it to build their biofilms!), and taking an iron supplement would feed their reproduction and activity while still preventing it from being absorbed into your body. In this case, you want to rebalance the gut bugs before deciding if you need an iron supplement. (You may find that correcting the dysbiosis allows you to absorb the iron you’re already consuming and no supplement is needed.)
- You don’t produce enough stomach acid, so the iron in the food isn’t being freed for absorption. The goal would be to figure out the stomach acid situation, as iron absorption won’t be the only thing impacted.
Also, don’t forget that nothing exists in a vacuum, and the interactions between a new supplement and any current supplements, medications and conditions should be considered. After all, you don’t want to add a pill to your regimen to discover a negative interaction.
3. Does the supplement need to be taken in combination with something else?
If you were to study the food traditions of many ancient cultures, you would be surprised to find that the way they combined and cooked foods often resulted in greater nutrient bioavailability (i.e., how much of the nutrient could be absorbed and used by the body). For example, the bioavailability of the active compound curcumin is much higher when turmeric is heated in a little fat (like butter or coconut oil) and combined with black pepper. In India, they often heat several spices together in fat before adding other ingredients to the dish.
As such, we may not be getting the benefits we seek, if we take everything as singular nutrients. To prevent this, be sure you know if it is okay to take the nutrient on its own or if you need to find a supplement that is a combination of nutrients or to take two different supplements to reap the rewards.
One example, which I’m sure you’ve already figured out, is that good curcumin supplements include fat and black pepper extract.
Another example is that most calcium supplements these days include vitamin D, because sufficient levels of vitamin D are required for the body to absorb calcium. However, keep in mind that a calcium supplement may not have enough vitamin D to sufficiently raise your serum levels, so you might need to consider a separate vitamin D supplement. As well, once the calcium is absorbed into the body, it still needs other nutrients like vitamins K2 and C to shuttle it into your bones… so calcium and vitamin D may not be enough to slow or reverse bone loss. (Isn’t the body wonderfully complex?!)
Although it seems otherwise, I promise it’s not a never ending list of supplements to be considered once you’re considering one! And it’s still worth your time to understand whether or not there’s a dependency you need to bear in mind when choosing a supplement.
4. How much do I need and how long should I take it?
Without some sort of inherited disorder (such as PKU or Wilson’s Disease), nutrient toxicity from food is virtually unheard of. In fact, I’ve never heard of it, but am not ruling out the possibility that it has happened some time! However, there are plenty of stories of people overdoing supplements and putting themselves in toxicity. This is especially true with fat-soluble nutrients as the body is capable of storing most of these (as opposed to water-soluble nutrients, which the body doesn’t generally store for future use) such as vitamin A, D, E and K.
As well, nutrients are often balanced by each other in the body. For example, we need both omega-3 and omega-6 fatty acids to stay healthy. However, we usually hear only about omega-3s because, generally, our intake of omega-6s is so high that the balance between the two is way off. (In Western diets, the ratio is around 1:16 rather than the ideal 1:1, thanks to an over abundance of processed vegetable oils and all things made with them.) The result is that many people think that supplementing with omega-3s, usually in the form of DHA and EPA, is a good thing. And it certainly can be! But if you eat a generally healthy diet that is low in omega-6 containing foods and you supplement with omega-3s, you may throw your body out of balance and cause problems like immune dysregulation.
To prevent this from happening, you must understand how much of the nutrient you need. Don’t get too little or it won’t do you any good. Don’t get too much or it could cause toxicity or imbalance in your body.
Next, you need to know how much your body can absorb at one time. (For example, taking < 200 mg of vitamin C results in an absorption rate of 98%, whereas taking 1000 mg has an absorption rate of < 50%.) Once you know how much you can absorb in one dose, you can determine if your supplement needs to be taken as a split dose, with one part taken at one time of day and another taken at another time of day. (As a side note, this is whay many high quality multi-vitamin / mineral supplements require 3 – 6 capsules per serving.)
Finally, you need to know if and when you can stop taking the supplement. If you have certain genetic mutations or if you are getting older so your body is less efficient or if your environment deems it necessary, you may have to take a particular supplement forever. But, there are plenty of situations where taking a supplement is a stopgap. For example, if you are in the process of healing a leaky gut that lead to nutrient deficiencies, then once the gut is healed and you have reached the right nutrient levels in your body, you may be able to stop taking the supplement and maintain appropriate levels through food alone.
5. Do I know what the possible side effects are and what to do if they show up?
Although many supplements are safe, some may have side effects which are uncomfortable at a minimum or dangerous at a maximum. For example, is a headache or a head-to-toe rash or fluorescent yellow pee related to your supplement? And if so, should you stop taking it when the symptom appears, reduce the dose or continue with the protocol? (By the way, depending on the situation, the right next step could be any of the three!) You will be in less danger if you know what to look for and what you should do if a problem shows up.
As I’ve said before, taking supplements can supplement an already nutritious diet in a way that takes your health to the next level. The key is to be sure that taking a supplement is the right thing for your body, and if it is, to do so in a way that is truly beneficial. If you’re curious how I apply this information to myself, check out my video for part 3 of this series where I show you which supplements I take on a regular basis.
Note: This is education and is not a recommendation for supplementation, nor should it replace the input from a qualified healthcare practitioner. If you are looking for personalized supplementation recommendations, contact me and we can work together to determine if supplements are appropriate for your health journey.
— Gropper SS, Smith JL. Advanced Nutrition and Human Metabolism. 6th ed. Belmont, CA: Wadsworth Cengage Learning; 2013.
— Mayo Clinic Staff. Phenylketonuria (PKU). In Diseases and Conditions. November 26, 2014. Accessed on March 2, 2016.
— Olmstead SF. Biofilms part 2: Breaching the barrier: Innovative approaches to systemic pathogenic biofilms. In ProThera, Inc. Practitioner Newsletter. March 2016.
— Oregon State University. Excess omega-3 fatty acids could lead to negative health effects. In News and Research Communications. October 28, 2013. Accessed on March 2, 2016.
— Simopoulos AP. The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharmacother. 2002;56(8):365-79.
— Tempel M, Chawla A, Messina C, Çeliker MY. Effects of omeprazole on iron absorption: preliminary study. Turkish Journal of Hematology. 2013;30(3):307.
— The George Mateljan Foundation. Vitamin K. In The World’s Healthiest Foods. Accessed on March 2, 2016.
— U.S. National Library of Medicine. Wilson’s disease. In Bookshelf. Accessed on March 2, 2016.