Supplements - Yes or No?

In today’s society it seems you can buy supplements for just about anything. Pills, potions, powders, and various tinctures are broadly available that make a variety of health claims. But do these actually work and should everyone be taking a supplement of some description? This is the question I normally get asked and it is important that we know the answer to avoid potentially harming our bodies or at the very least avoid unnecessary spending.

What Are Supplements?

Supplements originate with different ingredients and different potential health benefits or claims. These supplements contains but are not limited to:

Minerals – contain either several minerals in low dose in a multimineral formulation or come as individual vitamins e.g. selenium, zinc, copper etc.
Antioxidants – formulations comprising antioxidant compounds such as resveratrol, green tea extract, glutathione, n-acetyl cysteine etc.
Herbal Supplements – include liquid, powder or capsule herbal extracts e.g. vitex, silymarin, horny goat weed etc.
Vitamins – contain either several vitamins in low dose in a multivitamin formulation or come as individual vitamins or groups of vitamins e.g. multi B supplement.
Oils – can be found in capsule or liquid form and include krill oil, cod liver oil, fish oil, and flaxseed oil.
Probiotics – contain known strains of beneficial gut bacteria and come in liquid, tablet, or powder form.
Fibre Supplements – soluble and insoluble fibre supplement e.g. psyllium
Protein Powders – contains the protein portion of foods such as whey, rice, pea and soy often mixed with a fibre supplement and a sweetener.
Greens Powders – contain dried green plants including barley grass, spirulina, chlorella and wheatgrass.
Performance Enhancing Supplements – these include all sport related supplements – creatine, L-carnitine, branched chain amino acids, alpha-lipoic acid, d-ribose and glutamine.

Should Everyone Take Supplements?

The general thought that everyone and anyone should take the same supplements is incorrect. Our bodies have different needs and therefore some individuals may require additional support in the form of supplementation whereas others may get away without taking any supplements. Also, the desires of our body may change depending on our stress levels and other lifestyle factors, current diet, as well as our age; and so may our nutritional requirements change accordingly. Due to these situations we may need extra supplementation for only a period of time.

In an ideal world we would get all that we need from the food we eat. Indeed, food should ideally be our medicine. Choosing an extensive range of fresh fruits and vegetables of different colours, lean animal products, wholegrains , eggs, beans and other legumes, as well as nuts and seeds, aids to ensure we are getting enough nutrients.

Unfortunately, our diets can be lacking in certain nutrients due to poor nutritional choices, lack of available fresh foods or access to fresh foods, and even due to poor soil quality, which compromises the vitamin and mineral content of the produce we eat.

I encounter a number of mutual deficiencies in clinical practice including:

Iodine – can lead to thyroid problems resulting in fatigue and weight changes.
Vitamin D – can lead to osteoporosis, and may even lead to difficulty losing weight,
Iron – can lead to anaemia and fatigue.
Vitamin B12 – can lead to anaemia and fatigue.
Zinc – can lead to brittle hair and nails, poor energy, hair loss, digestive issues, and poor wound healing.
Magnesium – can lead to cramping, heart palpitations and constipation.
Vitamin D – can lead to osteoporosis, and may even lead to difﬁculty losing weight, autoimmune conditions, depression and certain types of cancer.

These deficiencies, luckily, can be detected by laboratory testing and are worth having tested yearly. There exists other common deficiencies recommended in scientific research to affect those living in Western nations that cannot be laboratory tested. These are vitamins A, B6, C, E, K, and potassium, selenium, as well as antioxidants. Largely these deficiencies are blamed on poor nutritional intake of the foods listed above. As a general rule I do not prescribe these nutrients unless I suspect from someone’s lifestyle, diet, and/or symptoms that they may be deficient.

Aside from the above common deficiencies there are certain circumstances where supplementation is recommended regardless of laboratory testing.

These include:

B12 – often given in cases of pernicious anaemia by injection form.
Calcium – often recommended for postmenopausal women who do not have enough calcium in their diet. It is significant to have a magnesium supplement as well as calcium.
Vitamin K – given as either injection or oral form to newborns to prevent potential bleeding due to low vitamin K body stores (vitamin K is used in blood clotting).
Coenzyme Q10 – this is important for energy production and is inhibited in those taking a Statin for high cholesterol therefore increasing the risk of muscle soreness. For those taking a Statin it is recommended to take coenzyme Q10 in its active form ubiquinol or reduced form to improve absorption into body cells. Some natural medicine practitioners also recommend coenzyme Q10 in those older than 50 years to improve energy as the natural production of coenzyme Q10 reduces with age.
Thiamine (vitamin B1) – often given in the case of alcoholism to prevent brain damage from alcohol poisoning.
Folate – in women planning to conceive and in the first three months of pregnancy. Also recommended in the situation of high homocysteine blood levels (a measure of heart attack and stroke risk). Also given to individuals on certain anti-epileptic medications as well as methotrexate medication.
Omega-3 fatty acids – often included in infant formula and thought to improve brain and cellular function. Often also recommended in those older than 60 years as a blood thinner and anti-inflammatory agent.
Vitamin B6 – often given in cases of mild morning sickness as well as for PMS.
Multivitamin/multimineral – given in cases where nutrition is lacking due to poor intake, poor absorption of food nutrients due to certain medical conditions, or due to medical conditions which cause an increase in nutritional requirements. I generally do not recommend multivitamins/multiminerals for everyone as they are not tailored to individual needs.