“Supplements don’t work!”
I hear this a lot from new clients. They come in with a shopping bag of half used bottles and claim that supplements are a waste of time...
My father is a holistic doctor and when I was 7 my mum started a chain of health food/supplement stores in the Bahamas. We took supplements to stay healthy and to treat illness and I spent many summers working in her stores before I became a doctor..Ive been in this industry my whole life, and i can tell you confidently that 1. reputable brands of supplements taken corrects definitely DO work and 2. There is a LOT of cheap crap on the market that doesnt……
Most of the people I see present with complex chronic conditions and mystery symptoms, have worked with many practitioners and impulse purchased many promising vitamins and herbal products.
And they are frustrated.
But before you blame the entire industry and write off natural products completely you need to ask yourself these questions:
1. Have you addressed the foundations of health first?
Vitamins, herbs and natural products are not miracle cures and are often much less potent than pharmaceuticals in the short term.
They are called SUPPLEMENTS because they are meant to supplement a healthy lifestyle and diet. Unless you are already taking steps to get enough sleep, eat well, reduce your stress and spend time outside, that's where you need to start. It is completely unreasonable to expect your multivitamin or herbal products to make you healthy if you routinely eat processed food, stay up until 11pm watching netflix and don't exercise. Work on your lifestyle, circadian biology and diet FIRST!
2. What forms are you using?
The form matters! Many over the counter vitamins and herbal products your purchase at the pharmacy or grocery store are derived from petroleum. B complex vitamins are often coal tar based and require multiple steps before they can be converted by the body into usable forms that are recognised by the body. For many people this may not be the end of the world, but for others with certain genetic variants, advanced age or illness your ability to make this conversion may be compromised meaning you may be depleting other vitamins, or having a buildup of unusable forms which prevent your body from using food based nutrients. This issue was recently brought to the mainstream with folic acid. Folic acid is not found in nature-folate is. Taking folic acid may not only be useless but may also inhibit your body using folate from plants in some individuals. Most good GP's/midwives now prescribe folate, folinic acid of 5-MTHF for pregnant women instead of folic acid for this reason.
In my practice i’ve generally moved away from prescribing any synthetic vitamins except in short term high doses in a quasi pharmaceutical way - Ie I will prescribe very high dose vitamin D3/retinyl palmitate for 3-5 days at the onset of a viral illness…I typically like people to obtain nutrients from food or prescribe food based nutraceuticals - Ie instead of NAC as a precursor to glutathione, i like to give sulforaphane from broccoli sprouts which turn on your body's ability to actually make glutathione.
Another benefit of food based vitamins/minerals is you often don’t need such high amounts as with synthetics (which ultimately mean less pills, less binders/fillers/excipients - see below).
This is also a HUGE issue for herbal and botanical products. Where the plant was grown, the species and subspecies, how it was harvested and processed all make a huge difference in its efficacy. Generally I recommend standardized herbal products which are guaranteed to contain the correct amount of certain phytochemicals needed at time of manufacture. Products with whole herbs may or may not be effective for certain conditions. Quality matters. If something is very cheap- there is probably a reason why…
3. How much are you taking?
This is KEY. Keep in mind when you buy a supplement, the dosage on the label generally applies to (about) a 150 lb/68kg person in good health. If you are taking something to treat a health condition or are heavier/lighter your dosage may be very different. If you sweat a lot, are very active or are highly stress your dose may also be much higher than recommended on the label. I recommend doing some research (www.examine.com is a great place to start for dosages) or speaking to a naturopathic doctor to find your individualized dose. A great example is 5HTP. Many supplements on the market (like the one i just purchased) are 50 or 75 mg per capsule. The bottle says a serving is 1 capsule and to take 1-2 per day. Now if i was using this to treat insomnia or low mood the evidence says the effective dose range is between 300-400mg. If i only took one per day...75mg wont do a damn thing. Conversely, if someone is taking a SSRI antidepressant and took 2 per day- this may be way too much. Individualized and precision dosing MATTER.
4. WHEN are you taking it?
Generally omega3's vitamins and minerals go WITH FOOD, many herbs, or amino acids should be taken on an empty stomach. This matters for absorption and efficacy. Also time of day matters. There is a complex circadian rhythm in the body, taking things when your body doesn't want to use them or isn't in a receptive mode means they wont work as well. This is even being released in the world of chemotherapy and even has a name - chronotherapy! Recent studies show that timing matters, and the same drug and dose given in the morning vs evening may have less side effects and be more effective. https://pubmed.ncbi.nlm.nih.gov/7626851/
Generally think of what your body SHOULD be doing and take supplements to support day/night time functions.
Daytime- your body is programmed to receive and digest food and nutrients so take most of your vitamins and omega 3 during the day. Sedating herbs obviously and calming nutrients often should be taken in the afternoon or at night. Many sleep supplements work best with dosing once in late afternoon/dinner AND again before bed.
5. How long have you been taking it (consistently)?
Again supplements are not miracle pills or as potent in the short term as pharmaceuticals. With the exception of cases of severe deficiency/some herbal products meant for acute conditions you likely won't see an effect in a few doses. Most natural products require you to take the correct dose for a period of at least 3 weeks. If you haven't finished the bottle, don't say it doesn't work-yet.
6. What other ingredients does your supplement contain?
Brands are ABSOLUTELY NOT CREATED EQUAL! Unfortunately the supplement industry is not well regulated and there is an incredible range of quality on store shelves. Not only do many cheaper companies use synthetic and poorly absorbed forms of nutrients in inappropriate dosages, but they often contain insane amounts of binders, fillers, excipients, shellacs and potential allergens- not to mention heavy metals!
Capsules generally are made from animal gelatin or cellulose, tablets typically require many more ingredients and excipients as well as things like shellac or glazes to make them look shiny. The often also contain artificial colors.
Herbal products and fish oils MUST ALWAYS have a statement of testing for contaminants & heavy metals. Reputable companies always have this declaration on the label.
Fillers, flow agents, and excipients are used to make the capsule making machines run smoothly and bulk up capsules so they look full. Ingredients like magnesium stearate, titanium dioxide etc may be fine in the long term but lead to issues with absorption or toxicity if taken in the long term. Look for brands with fewer excipients and always google ingredients you don't recognize.
Finally, be mindful that some supplements may have allergens. Vitamin C is generally made from corn or GMO beets, and many cheap Omega or vitamin D3 supplements contain soybean oil.
If you unknowingly take a product with a toxic ingredient or allergen, it may make you feel worse than not taking it at all.
7. How are you storing it and how quickly are you using it?
For products like fish oils, leaving them at room temperature may result in rancidity or oxidation of the delicate omega 3 oils, rendering them not just ineffective but harmful to the body. Once opened fish oils and many probiotics need to be stored in the fridge. Probiotics list the number of organisms at the time of manufacture. If you don't store them in the fridge you may have less than half (or no) active species at the time of consumption. Most botanical and food based supplements should be consumed within 6 weeks of opening to ensure efficacy.
8. Is your gut health a mess?
It's not "you are what you eat, but rather you are what you absorb"! If you have weak digestion, low stomach acid, slow transit time or other functional gut issues, you may not have the digestive fire to breakdown tablets or absorb nutrients. If you have a functional gut pathology I highly recommend opting for food based powdered supplements, liquids and sublingual products or even vegetable cellulose capsules over tablets.