It is very common for alternative medicine practitioners to prescribe lots of supplements to help people overcome a particular health concern.  Alternatively people just self medicate with supplements, which are available over the counter.

It is unlikely that this will cause any harm, but it can become very expensive with limited benefit.

If we split this article into 2 areas

·       General supplementation

·       Supplementation to deal with specific problems

General Supplementation

If we take this to mean supplementing to cover the basics and assume that you are eating a well balanced diet you should consider supplementing with Vit D3 (especially in the winter in Ireland) and Omega 3, both of which have some evidence of benefit (Bahrami et al, 2020) (Liao Y, 2019). There are even studies showing support for taking Vit D3 to help with Covid 19 & respiratory infection (McCartney & Byrne, 2020).

If for whatever reason you don’t eat a wide variety of vegetable you should add a multivitamin as well.

Many people are advised to supplement with Omega 3,6 and 9. This is often unnecessary as Omega 6 and 9 are prevalent in most diets already and it is the Omega 3 that is lacking. The best dietary source of Omega 3 is oily fish like mackerel and salmon.

Supplementation to deal with a specific symptom

There is no doubt that many supplements can really help some people. Magnesium, B vitamins, Calcium, Iron, Digestive enzymes, antioxidants, to name a few can all be really helpful.

However there are a number issues that I have with just supplementing and hoping for the best:

1.    Are you really helping by just supplementing, even if it makes you feel better, if you don’t understand why you are deficient in the first place?

2.    Most people do not look at their diet or gut health before supplementing – A healthy microbiome is more important than supplementing in fact many supplements will not work unless there is a health gut microbiome

3.    Many people who are taking supplements are just not taking enough to make any difference

4.    Many of the supplements on the market are not in their most beneficial form.

If we use B12 (cyanocobalamin) as an example to work through the 4 points above;

1. There are many reasons that someone may be deficient in B12. As the majority of B12 in our diet comes from animal products if you are a vegetarian or vegan supplementing would be a good idea. But many meat eaters are also deficient so there must be other mechanisms possible. One is an autoimmune condition where by the person is producing antibodies to intrinsic factor which is needed to absorb B12, gastrointestinal complaints or even lack of stomach acid will impair the absorption of B12.

2. In many cases the bacteria in our gut are competing for B12. Therefore someone with a significant dysbiosis can have a problem with absorption of B12 (Degnan et al, 2014).

3. What is a safe dose and which form should you be taking. With the possible issues with gut microbiome and B12 absorption it may be better to think about using a spray, liquid or supplement that dissolves in the mouth and by pass the gut altogether. 

4. The form of B12 is important. Many supplements are made from cyanocobalamin because it is stable but methylcobalamin and adenosylcobalamin are 2 better forms of the supplement as they are in the active state and immediately available for the body to use.

In my opinion supplements are not the whole solution and most people would benefit more with changes to their lifestyle and diet.

However if you are going to supplement here are some tips to make better choices.

·       Understand why you are taking a supplement

·       If you are taking a supplement for a specific condition and notice no difference in that condition consider stopping, or go back to your practitioner to discuss changing dose, or using a different formula.

·       Try to find out what is the best most bioavailable form of the supplement you wish to take.

·       Pay more attention to your overall gut health. Increase fibre in your diet and eat as many different kinds of vegetable as you can.  If you are concerned seek help

IMPORTANT

Before taking any supplement please check that it does not interfere with any medication you are taking, if in doubt check with your GP or the person who prescribed you the medication.

References

Bahrami, L.S., Ranjbar, G., Norouzy, A. et al. (2020) Vitamin D supplementation effects on the clinical outcomes of patients with coronary artery disease: a systematic review and meta-analysis. Sci Rep 10, 12923 (2020). https://doi.org/10.1038/s41598-020-69762-w

Degnan PH, Taga ME, Goodman AL. (2014) Vitamin B12 as a modulator of gut microbial ecology. Cell Metab.;20(5):769-778. doi:10.1016/j.cmet.2014.10.002

Liao, Y., Xie, B., Zhang, H. et al. (2019) Efficacy of omega-3 PUFAs in depression: A meta-analysis. Transl Psychiatry 9, 190). https://doi.org/10.1038/s41398-019-0515-5

McCartney DM, Byrne DG (2020) Optimisation of Vitamin D Status for Enhanced Immuno-protection Against Covid-19 Issue: Ir Med J; Vol 113; No. 4; P58.