Do we need Supplements?
On June 19, 2002, the Journal of The American Medical Association (JAMA) contained a scientific review article titled “Vitamins for Chronic Disease Prevention in Adults“, which addressed the debate regarding the use of vitamin supplements and the prevention of chronic disease in adults. After reviewing the body of evidence on this controversial subject, the researchers advised their medical colleagues that “the use of vitamin supplements is a prudent intervention in the fight against many chronic degenerative diseases.”
The researchers stated that vitamin deficiency syndromes such as scurvy and beriberi are uncommon in Western societies. However, suboptimal intake of some vitamins, even above levels causing classic vitamin deficiency, is a risk factor for chronic diseases. This scenario is common in the general population, especially the elderly.
Flash forward to a 2024 study published in The Lancet, Global estimation of dietary micronutrient inadequacies: a modelling analysis, in which the authors conclude “more than 5 billion people do not consume enough iodine (68% of the global population), vitamin E (67%), and calcium (66%). More than 4 billion people do not consume enough iron (65%), riboflavin (55%), folate (54%), and vitamin C (53%).”
To many of us this is a breath of fresh air after decades of skepticism from the medical community. But, starting supplements is not simply a matter of rushing down to the mega-mart for brand “X” of vitamins. There are many, many pitfalls in taking supplements.
Buyer Beware, What to look for
First of all, 25-50% of supplements are bogus, not even containing the ingredients listed, or so poorly prepared they are not well absorbed. To begin your search, look for a brand that has GMP, USP, or ISO 9000 type of certification. This means that the ingredients listed are truly in the product, and it has been tested for purity and safety.
Next, look for a broad spectrum supplement that includes all the necessary vitamins and minerals, anti-oxidants, and plant nutrients, with a specific list of ingredients. The key is getting the right ingredients in the right amounts. This should include nutrients that support the health of heart, bone, brain, liver, and eyes. It should also provide support for methylation, and defense against glycation, oxidation and inflammation (more later on these).
Avoid the inorganic mineral forms including carbonate, oxide, phosphate and sulphate. Do include mineral forms such as citrate, malate, succinate, aspartate and alpha-ketoglutarate. For example, calcium carbonate is bad, calcium citrate is good. The bad mineral forms are super cheap to make, poorly absorbed, and can even cause lower levels of other minerals. These cheap mineral salts are better laxatives than supplements!
Choose a form of Vitamin E that is the natural d-alpha-tocopherol with at least half gamma-tocopherol or mixed-tocopherols. Many studies have suggested that vitamin E supplementation increases the risk of prostate cancer – these poorly designed studies used only one of the eight forms of vitamin E which we know causes a deficiency in one of those other eight forms, the gamma-tocopherol portion, one of the most important anti-cancer forms of vitamin E.
The best form of Vitamin D, other than sunshine, is D3 or cholecalciferol. We should really check a blood level on Vitamin D to accurately determine the right amount to take.
Avoid potential toxicities. Don’t take more than 5000 IU of Vitamin A unless in the form of beta-carotene which will convert as much as needed to Vitamin A. Don’t supplement iron unless menstruating or directed by a physician.
Last is the issue of purity. Many supplements are contaminated with heavy metals such as mercury or lead. For example, calcium from oyster shells usually contains high levels of heavy metals. Unfortunately, our oceans are laden with these metals, and while good for a hard oyster shell, they are certainly bad for us! So, just because something is “natural” doesn’t guarantee it is good.
Our best nutrition is certainly through diet. We are designed to get 6-8 servings of fresh fruit & vegetables daily. The truth is that 90% of Americans don’t get even 5 servings daily. 90% of us! Even with a lot of effort, this is hard to do. Furthermore, because of synthetic fertilizers and lack of crop rotations, the typical leaf of lettuce doesn’t have the nutrients we think it does. It is a fact that organic gardening produces safer, more nutritious produce.
So, who should take supplements? Maybe not the red wine drinking, berry eating, organic gardening, mostly vegetarian salmon fisherman living in the pristine wilderness! Seriously, we all should.
Author
Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in bioidentical hormone replacement for men and women, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com). Call (970) 245-6911 for an appointment or more information.
