Do I Need Supplements?
A very common question that comes up a lot is - "Do I need to take supplements?" Why can't I just get all my nutrients from foods?"
I am a big proponent of obtaining the majority of our nutrients from foods, because they contain a synergistic combination of vitamins, minerals, and phytochemicals - which generally enhance the absorption and utilization by the body. But there are a number of reasons that we might not be getting all of the nutrients that we need on a daily basis - leading to nutrient deficiencies.
10 Causes of Nutrient Deficiencies:
Highly Processed Diet. One reason for nutrient deficiencies is simply that we simply might not be eating enough nutritious foods. The Standard American Diet (SAD) tends to be too high in packaged, processed and fast foods which is likely to be lacking in key nutrients. And to make things worse - processed foods also tend to deplete nutrients within the body, because the body uses them up trying to metabolize foods that are high in sugar, trans fats, chemicals and preservatives! Also - processed foods are generally made with poor quality fats that lead to inflammation. So they are a triple-whammy!
Poor soil quality. Even if you get the most stellar diet full of plant-based foods; because soils are increasingly becoming depleted of minerals, much of our food is becoming more depleted as well. Buying organic certainly helps, as organic food tends to be grown in better soil, and your body won't have to deal with all the pesticides either.
Low stomach acid or digestive issues. Stomach acid is needed to properly break down our food so the nutrients can be absorbed. If you have low stomach acid, you might not be effectively breaking down and absorbing the nutrients you take in. Low stomach acid can occur from taking antacids and PPIs, and also generally becomes even more prevalent as we age. Other digestive issues like food intolerances, bacterial overgrowth, infection, or another gut issues can inhibit the proper absorption and utilization of nutrients.
Anti-Nutrients. Some compounds in foods prevent the body from absorbing nutrients, these are called anti-nutrients. For example, phytic acids which are in grains, nuts, and soy; bind to and prevent the uptake of important minerals like zinc and magnesium. Soaking, sprouting and fermenting can in many cases reduce or eliminate phytic acids.
Missing Key Co-factors. Certain nutrients require other key nutrients in order to be properly absorbed and utlilized. For example, in order to get calcium into the bone, you also need key co-factors like vitamin D, magnesium and vitamin K and trace minerals. In fact, taking calcium alone can be harmful - as poorly absorbed calcium can lead to calcifications of the breast and arteries.
Prescription medications. Prescription medications can lead to a myriad of vitamin, mineral and hormone deficiencies, read the book Drug Muggers by Suzy Cohen, RPh to learn which medications deplete which nutrients, and how to replenish them.
Avoiding food groups. Whether it is due to picky eating, religious reasons, food intolerances, or for personal or health reasons - people might need to, or choose to, avoid certain food groups. This can potentially lead to nutrient deficiencies. Certain nutrients, like B12 are only readily available in animal products. So vegan diets - which exclude all animal products - can lead to a deficiency in vitamin B12. So it is important for anyone avoiding food groups to understand what nutrients they need to supplement in order to replenish key nutrients that could be missing from your diet.
Genetic factors. Certain genetic factors can lead to nutrient deficiencies (such as having a methylation defect like the MTHFR) due to a reduced ability to convert certain nutrients into their useable form. This can even lead to an increased risks for many conditions and diseases. If you want to know if you might have a genetic defect such as under-methylation, or a reduced ability to handle free radicals, you might want to consider having some genetic tests done. For example, poor methylators should take the active methyl-forms of certin B vitamins (such as methylcobalamin B12, not cynacobalamin) and folic acid (methylfolate, not folic acid). There is a genetic test for methylation, talk to your doctor if you want the test. This PureGenomics™ Multivitamin contains high quality activated bioavailable vitamins, and is designed for adults over age 18 with methylation issues.
Low Fat Diet, fat absorption issues. Did you know that in order to absorb fat soluble vitamins, that you need to have some fat with them as a carrier? So even if you are drinking lots of green juice, if you are not getting enough healthy fat with it, a lot of the fat-soluble nutrients are not being absorbed. So make sure you are getting healthy fat every day, and if you have issues digesting fats (i.e.: gallbladder trouble or removal) consider taking a digestive enzyme with bile salts to assist in the digestion and absorption of fat and fat soluble vitamins.
Sunscreen. Vitamin D is absolutely essential for a healthy immune system. But because the sun is the best source of vitamin D, avoiding the sun or loading up on the sunscreen every day can lead to deficiencies in this important nutrient. Dermatologists should not only recommend sunscreen, but also test for Vitamin D levels.
How Can You Tell if You Have Deficiencies? Do I need to take supplements long term?
There may or may not be symptoms at all, but nutrient deficiencies can show up in many different ways - ranging from fatigue, weight gain, migraine headaches, neurological symptoms (like tingling and numbness), skin issues (like dry skin, "chicken skin," or rashes); focus or memory issues, mental health issues like depression, lowered immunity, elevated homeocystene, weight gain or loss, loss of appetite, loss of taste or smell, and much more. When a symptom arises from a nutrient deficiency, taking a supplement to correct it makes sense. Sometimes, nutritional deficiencies can become severe, and even can be misdiagnosed as a "disease" (such as B12 deficiences that can mimic dementia, MS, and other conditions).
If you do decide to supplement, you might still have questions - which nutrients do I need, and how much should I take? If you want to know exactly what nutrients you are deficient in, in order to more effectively target your supplementation - consider getting the SpectraCell Micronutrient test - which tests white blood cells to measure the functional levels of 35 nutritional components including vitamins, antioxidants, minerals and amino acids.
Some supplements we might use for a short period to support the body to recover from a particular issue (such as during cold and flu season - read 8 Natural Colds and Flu Prevention Tips), or if we are dealing with an issue that we are hoping to resolve like adrenal fatigue, or digestion trouble, etc). Other supplements we will want to take daily/long-term to support general overall health and prevent deficienices, disease and illness. Below are 5 supplements that pretty much everyone can benefit from.
The Top 5 Supplements (Pretty Much) Everyone Needs:
1. Magnesium: "The calming mineral"
I put magnesium in the #1 spot - because almost everyone is deficient. It is estimated that over 70% of the population is deficient in magnesium which is required for over 300 enzymatic reactions, including the synthesis of fat, protein and nucleic acids, muscular contraction and relaxation, nerve health, bone building, and heart health. Magnesium improves blood flow and plays a key role in serotonin production, protein building, and the metabolism of adenosine triphoshate (ATP). Magnesium helps rid the body of toxins and acid residues, and is also needed for the synthesis of vitamin D and absorption of calcium.
Magnesium is a nutrient that could save your life - literally! In emergency rooms they give magnesium to people who have suffered a heart attack, because studies have shown that IV magnesium after a heart attack offers protection to the heart muscle and could lower the risk of dying from a heart event.
One of the most important minerals for our heart health, magnesium is also emerging as an important mineral for cancer prevention. A study from Sweden reported that women with the highest magnesium intake had a 40% lower risk of developing cancer than those with the lowest intake of the mineral.
Heavy alcohol consumption depletes magnesium, which could be one reason that drinking more than two alcoholic beverages a day raises our risk of breast cancer and heart attack.
Magnesium is also important for our bone health. About two thirds of all magnesium in our body is found in our bones. It is also required for synthesis of vitamin D, which plays an important role in bone building.
Magnesium is important for our metabolism - as it has been found in studies to stimulate the release of adiponectin, which is known as a “fat-burning hormone.” So low levels of magnesium could be causing us to hang on to fat longer! Magnesium has also been shown to improve insulin sensitivity, another important factor in a healthy metabolism.
Low magnesium levels can cause muscle cramping, headaches, chest pain/arrythmias, and much more. Learn more about how magnesium deficiency could be harming your health: Magnesium: An Invisible Deficiency That Could Be Harming Your Health
Food sources of magnesium include leafy greens, seeds (like pumpkin), avocado, broccoli, and beans. But perhaps the best (and most delicious) way to get magnesium is from raw cacao – the main ingredient in dark chocolate.
If supplementing, look for malate, orotate, glycinate, or citrate forms (avoid the oxide form, which is poorly aborbed and more of a laxative). Too determine the right amount of magnesium for you, read this article by The Magnesium Miracle author, Dr. Carolyn Dean: Magnesium Burn Rate & Dosage.
2. Vitamin D - the "sunshine vitamin"
Referred to as the “sunshine vitamin”, Vitamin D is not really a vitamin, but a fat-soluble pre-hormone that in synthesized from exposing the skin to the sun. Not surprisingly after years of slathering on the sunscreen – many Americans are now low in vitamin D levels. A study published in 2009 in the Archives of Internal Medicine, found that 70% – 97% of Americans have insufficient blood levels of Vitamin D.
Why is Vitamin D deficiency a concern? I can not emphasize the importance of this nutrient enough - having optimal levels of Vitamin D could literally save your life!! It is estimated that up to 70% of breast cancers could be prevented with optimal levels of vitamin D. Insufficient levels of vitamin D raises our risk of fractures and osteoporosis, inflammation, leaky gut, MRSA infections, heart disease, and breast cancer. Vitamin D plays a role in cell growth and immune system function. Our immune system is significantly reduced when we are deficient in vitamin D, it is so important to our immune systems, that vitamin D is shown to be more effective in preventing the flu than the flu shot. A 2012 University of Copenhagen study found a link between low vitamin D and heart disease, and a study at Oregon Health and Science University linked low vitamin D levels to multiple sclerosis. Several studies have also found a link between low vitamin D status and difficulty losing weight.
How to get it: The sun is our best source of vitamin D. And you don't need a lot - 15-20 minutes most days of the week - should do the trick for most people. But because vitamin D is so critical, some people, especially those that avoid sun exposure, may want to consider supplementing.
If supplementing, you always want to buy vitamin D3 (not D2). Most adults can benefit from 2,000 IU of D3 a day.
Ideally, you should have your blood levels of vitamin D levels checked at least once a year, because if they are low (below 30 ng/ml), your doctor might temporarily want you on a higher dose. Below 20 ng/ml is the danger zone where fractures and cancer risks skyrocket!
What if you are supplementing and your D levels are not rising? You could have a genetic defect that reduces your ability to convert Vitamin D. Or you could be deficient in a very important mineral needed for the conversion of vitamin D - magnesium! I always recommend taking vitamin D with your magnesium supplement - because magnesium is required for the conversion of vitamin D into it's active hormone form. Many people will find that they can get their vitamin D levels up just by supplementing with magnesium!
3. Omega 3s - "Brain and mood food"
Two kinds of polyunsaturated fats – the omegas - are called “essential” because the body can not make them, so they must be obtained from the diet. Having the right balance of essential fatty acids is important in preventing inflammation. Ideally we should be getting around a 1:3 ratio of omega 3 to omega 6 fats in our diets. But because most processed foods are made with cheap soy, cottonseed or vegetable oils; which are high in omega 6s, most people today are getting closer to 1:20 ratio of omega 3s to omega 6s. Omega 6's promote inflammation - so diets high in omega 6s set us up for chronic and systemic inflammation. Omega 3s reduce inflammation in the body, which is very important for disease prevention.
One common sign that you could be deficient in omega 3 fats is having raised bumps, sometimes called "chicken skin," on the backs of your arms.
Omega 3 fats are important for healthy brain function, to support a balanced mood, for heart health, and have even been studied by the US Military to be effective in treating post-traumatic stress disorder. Omega 3s are found in fatty fish, some nuts, chia seeds, hemp hearts, and also in grass fed meats, and pastured chicken eggs. You can supplement with a high quality fish oil. And I like to take chia seeds every day too, which are high in ALA omegas. This article can help guide you on choosing a high quality fish oil. (note: high doses of fish oil can thin the blood, so they should be stopped a few weeks before any surgery, and consult a doctor if on medication).
Note: A recent study found that very high amounts of fish oil were linked to an increased risk for prostate cancer - but the design & conclusions of that study have come into question. There is a lot of research showing that omega 3s reduce cancer risk, including breast cancer.
4. Probiotics - feeds the digestion and immune system
Humans have trillions of bacteria in our bodies, in fact we are made up of 10 times more bacterial cells than human cells, so technically we are more bacterial than human! Bacteria live in our digestive system, our skin, and mucus membranes - our bodies are literally teeming with them.
There are between 500 and 1000 different types of Digestive Defense Probioticsbacteria in our guts alone! Bacteria play an extremely important role in our metabolism, digestive and immune system health. Perhaps even more than we currently realize.
When it comes to bacteria, it is all about balance. Research shows that ideally we should have 20 times more beneficial bacteria than the unhealthy kind to maintain a healthy immune and digestive system. A balanced inner ecosystem is very important for digestion, immunity, mood, and even has an impact on your weight. There is even some very good research suggesting that it could be a player in the fight against heart disease and diabetes.
You can get good bacteria from fermented foods like sauerkraut, kim chee, kombucha tea, and yogurt. But most people do not get enough fermented foods, so I recommend that most people takes a high quality probiotic supplement to make sure to keep the good bacteria outnumbering the bad.
One of my favorite probiotic strains to start people on is called Bacililus Coagulans - because it is a soil-based probiotic strain that helps to "seed" the gut, it is also shelf stable (which means it does not need refrigeration), it gets past the harsh stomach acid to where it belongs (the colon), and is a strain that is generally well tolerated by most people.
Some people may not tolerate probiotics well - such as those with an overgrowth of bacteria in their gut (SIBO). Talk to your health practitioner if you have concerns or questions.
5. B Vitamins - the "Stress vitamins"
The B vitamins are critical for a healthy metabolism and are needed in order to convert our food into energy. Often referred to as the stress vitamins, the B vitamins are water soluble, so they are not stored in the body for long, and stress causes us to excrete them more. B vitamins are important for energy, mood, sleep, nerve function, detoxification, digestion, heart health, and more.
Here are some of the key ones:
Vitamin B12 is important for energy, mood, memory, and focus; as well as the metabolism of fats and protein. A B12 deficiency can cause fatigue, depression, anemia and nerve damage. Because B12 is naturally only available in animal proteins, it is very common for vegans to be deficient unless they are supplementing. Having inadequate levels of stomach acid can also cause a B12 deficiency. B SupremeFood sources include: sardine, cod, tuna, chicken, beef, and salmon.
Vitamin B6 is important for metabolism of carbohydrates, sleep, anti-inflammation, gallbladder health, and hormone balance. A B6 deficiency can lead to PMS, low levels of serotonin or other neurotransmitters, and gallbladder trouble. Taking birth control and hormone replacements depletes B6. Food sources include tuna, turkey, chicken, salmon, beef, sweet potato, beans, and banana.
B9 (Folate): Important for prevention of colon cancer, heart disease and stroke, and birth defects. Folic acid deficiency can show up as elevated homocysteine, which can damage blood vessels and raise the risk of heart disease. This can happen despite adequate dietary intake of B vitamins if someone has problems with methylation (conversion of the B vitamins). But watch out for foods that contain folic acid - which is a synthetic form of B9 that is not converted as well as folate, and could actually be detrimental to health (learn more).
B5 (Pantothenic Acid) is important for skin and adrenal health, blood pressure and the thyroid.
B1 (Thiamine) is needed for carbohydrate metabolism and can be useful for those with digestive issues. Food sources include animal proteins, fish, eggs, and dairy.
B3 (Niacin) is important for the production of hormones, including the stress hormones. Note: higher doses can be toxic to the liver.Screen Shot 2016-04-26 at 7.02.02 AM
B2 (Riboflavin) deficiencies could lead to migraine headaches.
B7 (Biotin) is important for healthy skin, hair and nails. Biotin is found in organ meat, cheese, and soybeans.
Below are some other common nutrients that certain people might want to consider supplementing:
Vitamin C: An important antioxidant that supports a healthy immune system, collagen production, wound healing, iron absorption, neurotransmitter synthesis, detoxification, and helps to lower the stress hormone cortisol; many people can benefit from supplementing with vitamin C- especially during colds and flu season, and times of stress - which increases the body's need for vitamin C.
Iodine: Important for thyroid health and prevention of breast cancer, iodine is known to uptake heavy metals, which can interfere with thyroid health. One of the best food sources of iodine are the sea vegetables, particularly kelp. Iodine should be taken with selenium. Note: persons with hyperthyroidism or autoimmune thyroid should talk to their doctor about iodine, as it can "rev up" the thyroid too much.
Selenium: a very important trace mineral that is important for the immune system, thyroid health and even skin and breast cancer prevention. One of the best food sources is Brazil nuts - in fact, they are so rich in selenium that you can eat too many of them. Just about 4 a day can get you to optimum levels of selenium.
Zinc: Important for hormones and growth, low zinc levels can lead to short stature and delayed growth/puberty in kids. Zinc is also important for detoxification, wound healing, and immune health. Some signs that you could be zinc deficient is a lack of sense of smell or taste, low appetite, poor memory, poor wound healing, or frequent illness. Food sources include oysters and cashews. Note: avoid long term daily supplementation of zinc above 40 mg. of zinc, becaues it can lead to copper deficiencies.
CoQ10: Very important for energy production and cellular health, our production of CoQ10 declines with age. Another thing that severely depletes our CoQ10 levels are taking Statins. If you are taking a statin - ask your doctor about supplementing with CoQ10.
Calcium: Our needs for calcium vary throughout our lives, but one group that is probably not getting hitting their calcium requirements are teenagers, who need about 1,300 mg/day. But taking calcium alone is not going to get the job done, in fact - taking calcium alone is a VERY BAD IDEA, and can lead to calcifications - which can raise your risk for a heart attack. Calcium needs to be taken with the co-factors magnesium, vitamin D, vitamin K, and trace minerals in order to be absorbed into bone. Even milk is missing some of the key co-factors for absorption. The only calcium supplements I recommend are algae-based calcium with the key co-factors needed for absorption - such as Alive brand Calcium. Make sure to still also get your calcium from foods too - broccoli, sardines, sesame seeds, and dark leafy greens.
Although we should obtain the majority of our nutrients from foods, most people can benefit from high quality supplements. But you also want to be careful to not overdo it - more is not always better when it comes to supplements - especially because some can accumulate in the body - like the fat soluble vitamins, or iron.
When supplementing, I always caution people against buying the cheapest option, or 'whatever is on sale.' When it comes to supplements - you truly get what you pay for - and quality is absolutely key. Poor quality supplements tend to be poorly absorbed, and worse – they might even do harm. For example, cheap calcium supplements that do not contain the key co-factors for absorption into the bone, can cause the calcium to migrate to where it should not go, potentially causing calcifications of the arteries, and an increased risk of heart disease.
If you do choose to supplement, realize that supplements alone can't replace a healthy diet, that is what they are called supplements!
Before starting new supplements, those taking prescription medications or who have an existing health condition should consult with their doctor first to make sure there are no interactions or contraindications.