Are Supplements Necessary?

supplementThere has been a lot of talk regarding the necessity, or not, of vitamin supplementation. Some argue that our poor, inadequate diets require it. Others purport that we glean enough from the variety of foods we eat in addition to fortification of grains, so taking supplements is just a huge waste of money. Who are we to believe?

I get asked this question every day. “Should I be taking a supplement?” My answer? It depends. I agree that not everyone needs a supplement. Our ancestors went without popping pills every day and arguably did ok, in most cases. Maybe this fight against supplementation is warranted. On the other hand, we all know people and specific cases where supplements were extremely helpful. Iron deficiency, B12 deficiencies, and Vitamin C deficiencies are just a few examples. Also those with clearly inadequate diets would, I believe most would agree, benefit from some sort of supplementation.

What is the correct answer then? Again, it depends.  There are so many factors that should go into the decision of whether to take a vitamin or not. Despite what online articles might tell you, it’s not a black or white issue. Let’s walk through the areas I typically assess with clients to determine if supplements are worth considering.


1. The number one factor I assess when determining the need for vitamin supplementation is the client’s current diet. Are they getting a varied diet, supplying a variety of nutrients throughout the day? Or, are they eating the same foods every single day, many of which are nutrient-poor? If the client’s diet is not meeting their needs, of course the first step is to help them correct the issue. Along with better diet, however, supplementation can be helpful in rebuilding nutrient stores in the body. Sometimes we recommend specific nutrients of concern, say calcium, Vitamin D, B vitamins, etc, and other times we go straight to a multivitamin to help cover all the bases. Our goal is to support health through optimal nutrient status, and supplementation, at least in the short term, is one way to help clients achieve that.

2. The next factor I always address is overall health. Are there specific disease states that my increase the need for certain nutrients? Are there potentially genetic factors whereby the client does not use nutrients as optimally as they should, thereby requiring a higher intake to enhance absorption? In these cases, short-term or long-term supplementation at regular or sometimes much higher doses are warranted. Please note that vitamin supplementation for disease conditions or at higher doses than commonly recommended should be evaluated by a medical practitioner before commencing.

For example, some diabetics may be deficient in chromium. Chromium is a micronutrient that works with insulin to help it do its job. Obviously insulin function is very important to a diabetic, hence a diabetic might consider chromium supplementation in their treatment plan.

In terms of genetic issues, one example is someone with the MTHFR mutation, which causes a defect in the enzyme that helps convert folate into methyl-folate. Methyl-folate then goes on to make another product called SAMe via another enzymatic process, which is then used used in hundreds of reactions throughout the body. If someone is not utilizing their folate as they should, symptoms can result. Supplementation can be a huge and necessary help.

3. The third area I address is lab data. Does the client have lab results reflecting overt deficiencies? Often many people don’t even realize they have a deficiency until testing is done to assess. Based on lab data we can pinpoint appropriate supplements that might be necessary in the short-term to correct a nutrient problem before it becomes a major health concern that they do realize.

4. And the last area I assess is general need based on location. I live in the Pacific Northwest. We are chronically Vitamin D deficient. Almost all of my clients should be taking some level of Vitamin D. Iodine is another example. Some parts of the country and in some communities in particular iodine-rich foods are almost non-existent. These groups might benefit from standard supplementation when there are known, widespread deficiencies.


So now that we have a better understanding of how to assess when and where nutrient supplementation might be needed, the next big question I often get is asked is, “Does it matter which brand I take?” The answer to that question is yes!

Quality is a huge concern in the supplement world. That is probably the number one reason supplements in general have a poor reputation. Numerous reports and studies have caught supplement manufacturers lying about the contents of their products or outright deceiving customers on what they even contain.

You may remember this story from a couple of years ago where several herbal products in common retail stores (Target, various drug stores) were tested for authenticity. They found that many of the products they looked at did not even contain the herb listed. In fact, some were filled with common houseplant substances instead of the healing herb they were touting.1  I can see why consumers would be suspicious. (see story link below)

Clearly, you do need to be careful about the products you choose. Unfortunately the choices are overwhelming, even to me! How do you decide?

The easiest answer is to ask your health practitioner what, if any brands, they use or recommend. I personally have my go-to’s that I know are safe and effective. Other practitioners have their trusted products. Typically these are from well-known, established companies with documented testing procedures, quality control measures, etc. Many of these brands are trusted and recommended by doctors, naturopaths, dietitians, and chiropractors. Some can be found at your local supplement store, and others need to be obtained at a natural pharmacy or online. Almost none, just for reference, come from the local drug store (Walgreens, Rite Aid, etc). It’s usually best to buy from a reputable supplement store, and even better to walk in with a specific product in mind, lest you get confused and/or tempted by the multitude of options.

Conclusion? Despite what media reports might say, supplements can be useful. Does it mean you need to run out today and get a general multivitamin just to be safe? Absolutely not. The key above all else is to improve your diet choices for optimal health and then evaluate if further “assistance” is needed. Don’t pay attention to all those latest fads on TV telling you what you need. Eat healthy, listen to your body, and employ the advice of a qualified health practitioner to better assess what supplements would be helpful, if any. You will save yourself a lot of time and, not to mention, a heap of money.

If you are not feeling at your best and wondering if supplementation is something you should consider, or if your medicine cabinet is jammed full of supplements and you are not sure if they are the right ones, reach out! We can do a general assessment to figure out what you need to make sure your body is working at its best.

1. https://www.washingtonpost.com/news/morning-mix/wp/2015/02/03/gnc-target-wal-mart-walgreens-accused-of-selling-fake-herbals/?utm_term=.1618f3899833

Bone Health: It’s Not All About Calcium

bone healthSeems every time we read about supporting healthy bones we talk about Calcium. “Drink milk for strong bones!” Who hasn’t heard that before? Who hasn’t seen a concerned look from a doctor or pediatrician when you say you or your kid isn’t eating many dairy products? And who hasn’t in some time in their life taken a calcium supplement in hopes of preventing bone loss and osteoporosis?

Thing is, we love our bones. They are pretty cool. They protect our organs, provide structure to our body frame, help us move, and even perform many metabolic functions such as store minerals, help balance the pH in our body, and even store fat in the yellow bone marrow, among other jobs. Yes, bones ones are pretty darn cool. Unfortunately how to protect them, beyond more and more calcium, is not widely publicized. I’m not sure why that is.

You see, we need far more than just calcium to achieve optimal bone health. In 2007 researchers found no correlation between increased calcium consumption and decrease in risk for hip fracture (1). Another study in 2014 showed that increasing milk intake during teenage years did not result in lower hip facture rates as adults (1). These are just a few of the studies showing such correlations. Clearly something is missing. Let’s talk through some of the other, less popular nutrients that are critical for calcium utilization and bone formation.

Vitamin D
Ok, Vitamin D is pretty popular, especially here in Washington State where we just don’t get adequate sunlight to synthesize enough of it. A study conducted in Great Britain, which is at a similar latitude to Washington, showed that Vitamin D deficiency amongst the general population during the Winter and Spring months was especially high (3). There is real cause for concern that some of us are deficient in this important nutrient. Its role is to help Calcium get absorbed from the bloodstream and therefore helps mineralize the bones. That seems pretty important. In other words, you can take loads of Calcium all day long, but without Vitamin D, it might not get where it’s needed.

If you are indeed Vitamin D deficient, what is the best way to correct it? Well, limited sun exposure during the warm months is one way. Supplementation all year, especially during the colder months, is naturally another way. Dosage? Unfortunately theories on dosing run all over the map, with standard intakes recommended at 400IU per day for ages 12 months and under and 600IU/day for kids and adults, up to mega high doses of 50,000IU and higher depending on the situation. Best course of action is to talk with your medical provider about what is appropriate for you.

Vitamin K
This is one under-appreciated nutrient. Most of us may think of it in relation to blood clotting, but it’s also a critical friend to calcium. Vitamin K helps create one of the most abundant proteins in the bone, Osteocalcin. Osteocalcin supports the bone matrix by binding calcium and promoting mineralization. Our bones would be at risk for weakness without it.

There are two forms of Vitamin K, K1 and K2. Vitamin K1 is found in green vegetables and supports healthy blood clotting. Vitamin K2, which is made by bacteria lining the GI tract (partly by converting some K1 into K2), is the form that supports bone health. How do we get enough? Leafy greens and green vegetables, as mentioned above, are great sources of K1. Some of that K1 will get converted to K2 which is the form we want for bone health. Another option is to supplement with K2 which will give a direct dose of the stuff our bones need. If you feel your health is pretty good, especially in terms of digestion and gastrointestinal health, some Vit K food sources daily may be enough. If you question your ability to properly absorb and convert Vit K to its active bone-health form, you may want to consider supplementation.

Magnesium
About 50% of our magnesium is stored in the bones, so this mineral has to be important. Several studies have shown that bone density increases as magnesium intake increases. This is one mineral not to ignore as it also supports a host of other functions in the body. One problem noted in recent years is that our food supply is becoming increasingly deficient in this vital nutrient. As soil supplies become depleted, so also does our food. Therefore it’s becoming harder and harder to know if we are getting enough from sources that are typically high in magnesium. These foods include nuts, beans, whole grains, and green leafy vegetables. The RDA for magnesium in women and men is 310mg per day and 400mg per day, respectively. Thankfully supplement options are abundant if you feel you need a little additional support. One word of advice? Unless you suffer from constipation and need some laxative help, try avoiding Mg+ Oxide and go for another form such as Mg+ Citrate, Mg+ Malate or Mg+ Glycinate which tend to be more readily absorbed.

Calcium
Last but not least, let’s talk about calcium’s role. It is critically important, as much as I have underplayed it to highlight the role of calcium’s best friends. But truly it is one of the most important players in bone strength. There is roughly 1 kg of Calcium in our bodies and 99% of that resides in the bones. It makes up a mineral complex that provides strength and stability to our entire skeleton. When they say calcium builds strong bones, they aren’t kidding. But as we have talked about throughout this entire article, calcium can’t get into the bones and do its job without its main helpers. This complex interplay between a vast array of nutrients, most of which we talked about here, is what keeps us strong and functioning at our full capacity.

The RDA for adults is roughly 1,000mg per day. BUT, this is dependent on ensuring adequate intake of all the nutrients needed for bone health. Otherwise, as mentioned previously, those 1,000 mg of calcium are not going to be well absorbed. And if they don’t get absorbed? Well, that is when calcium starts roaming for other places to live, like in your blood vessels, in soft tissues, in the kidneys, and excreted in the bowels, sometimes causing constipation.

To get adequate calcium, food sources are your best bet. Obviously dairy is the most touted, but for those of us who are dairy intolerant and dairy sensitive, there are other sources as well. These include beans, salmon, sardines, figs, leafy greens, almonds, chia seeds, tofu, and dairy free products that are fortified with calcium.

Oh wait, one more: Exercise!
How could we adequately talk about bone health without mentioning exercise? You see, the cool things about bones is that they are a living tissue and do respond to external stimuli, like exercise. The more force that is placed upon the bones the more they respond by becoming stronger. This is why weight-bearing exercise is the best form of exercise to give those bones a boost.

Types of weight-bearing exercise? Well, anything that causes impact on the bones counts. Brisk walking, hiking, jumping, dancing, cardio gym classes, stair climbing, team sports, and good ol’ weight training. If you don’t need to do exercise for your weight, at least do it for your bones!

Hopefully you now have a better understanding of the complete package when it comes to bone health. It’s not all about calcium, although its role is certainly vital. I think the real take home message is that a well-balanced, varied diet is key. These nutrients we discussed today, in addition to a host of others, play with each other in very intricate and complex ways to support this thing we call the human body. Rarely does isolating one nutrient alone solve the problem. All these nutrients depend on each other, like friends, to get important jobs done. As you can see it is a complex job, so give your body the tools it needs by eating a varied diet and incorporating daily exercise.

  1. http://www.ncbi.nlm.nih.gov/pubmed/18065599?dopt=Citation 
  2. http://www.ncbi.nlm.nih.gov/pubmed/24247817 
  3. http://www.ncbi.nlm.nih.gov/pubmed/17344510

If you have specific concerns about your health, especially pertaining to optimal bone health, don’t hesitate to reach out. It’s never too late to start doing what’s right for your main support system, your bones!

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