Should everyone be taking health supplements?
This is something that we, as naturopathic doctors here in Toronto, get asked a lot about from our patients
Walking into the supplement section of any grocery, health food or drug store can be overwhelming to say the least.
The options are endless and the prices are ever increasing.
It’s hard to keep track of what Dr. Oz or Dr. Google recommended.
Internet searches often give us expansive lists of contradictory information.
The Nutraceutical industry is rapidly growing and just as profit driven as pharmaceutical industry.
The following article will shed some light on how to approach supplementation in a critical and informed manner.
What are supplements?
In the true sense of the word, supplements are an addition of a macronutrient (protein, fat, carbohydrate) or micronutrient (vitamin or mineral) normally found in the diet.
Supplements can also be pharmaceutically synthesized molecules that are naturally occurring or built in the body (like GABA- a neurotransmitter or melatonin- a molecule involved in sleep).
Unlike drugs, whose components are synthesized and not found in the diet or naturally occurring within the body, supplements contain molecules which the body inherently knows how to absorb, metabolize and incorporate into physiological processes.
Drugs often change or inhibit a naturally occurring process, whereas supplementation corrects for deficiencies and optimizes inherent function.
What supplements should I actually be taking?
It depends. Each person has unique requirements based on individual factors and intended effect.
Most commonly, supplementation is indicated in cases of deficiency (common deficiencies include: iron, B12, vitamin D).
Symptoms vary depending on which nutrients are deficient. Deficiency can be caused by inadequate dietary sources or decreased absorption due to digestive dysfunction.
Many medications also deplete certain nutrients (the birth control pill for example, depletes vitamin B6). Many vitamins act as cofactors: molecules that make reactions happen- analogous to a catalyst in an engine.
As such, supplementation can also be used to up-regulate processes in the body.
For example, vitamin B6 is required for the synthesis of serotonin from the amino acid tryptophan.
Continuing with the car analogy, if we supplement with tryptophan, the gas, and B6, the catalyst, theoretically we should have increased serotonin- or a smoothly running car.
On the other (pharmaceutical) hand, selective serotonin re-uptake inhibitors (SSRIs/antidepressants) work by altering receptors so that more serotonin remains available.
How do I know how much to take?
Like pharmaceuticals, you need to take specific dosages of supplements in order for them to have their intended therapeutic effect.
Furthermore, many supplements have misleading dosing information on their labels.
For example, the therapeutic value fish oil lies in its omega-3 content (EPA and DHA). A 1000 mg Jameson fish oil has 180 mg EPA and 120 DHA mg in one capsule where as a professional line has 600 mg and 400 mg respectively.
You would need to take at least 3 capsules of Jameson brand fish oil to equal 1 capsule of the professional line.
Are all supplements safe and free of side effects?
No. High doses of certain supplements can be toxic and dangerous.
For example, high doses of supplemental vitamin D can cause kidney damage, niacin (vitamin B3) even at low doses can cause significant vasodilation (flushing), magnesium and vitamin C can cause diarrhoea, iron often causes constipation and zinc can induce nausea and vomiting.
Can I get everything I need from a healthy diet?
Assuming that a healthy diet is rich in fruits and vegetable, healthy fats (nuts and fish), and proteins (grains, legumes and meats) you may still fall short of certain nutrients due to inherent nutrient depletion in soil and decreased availability of certain foods.
Additionally, when supplements are prescribed at high dosages to enhance a specific function, it would be near impossible to achieve equal intake of that constituent through food alone.
For example, a dose of 4000 mg of vitamin C would require consumption of 80 oranges.
Does Vitamin D comes from the Sun?
Vitamin D doesn’t actually come from the sun.
However, exposure to the sun (specifically UVB light radiation) converts a precursor molecule to the active form of vitamin D.
This conversion happens subcutaneously (just underneath the skin) and requires sunlight.
The amount of skin exposed to the sun is proportional to how much vitamin D our skin makes. How much skin do Canadians expose to the sun in the winter?
Most supplementation should be individualized and supervised to have true therapeutic value.
Self prescribing can be ineffective and dangerous.
All supplements are not created equal.
When comparing brands, look at the amount of content in milligrams in each capsule.
For Canadians, supplementing vitamin D in the winter is appropriate in almost all circumstances
Yours in Health,
Dr. Marnie Luck, N.D