Supplements

Apr 27, 2024

Health

Today's Topic: Supplements

Half of America has used at least one supplement. And why not? They’re advertised to help us live healthier and longer!

But I’m a skeptic about everything. So, the wellness world telling me I can replace the value of whole foods with pills set off alarm bells.

I spent some time digging into whether supplements do what the ads say — and they kind of don’t.

What are supplements?

Supplements are substitutions of dietary nutrients.

Dietary nutrients (vitamins and minerals) are required to carry out bodily functions. Our bodies don’t produce them, so we need to ingest them. [1]

Most of us need varied vitamins and minerals. If your body doesn’t get enough of one or several of them, you can boost your intake with a supplement.

It’s a pretty broad definition. A “supplement” is anything from your Flintstones multivitamin to the creatine you take before your lift.

Three reasons why supplements don’t always work

Before I go further: if your doctor instructs you to take a supplement, you should listen. Your newsletters should not overrule your doctors.

Regulation bending

The Food & Drug Administration (FDA) doesn’t regulate dietary supplements and manufacturers are not required to submit evidence of purity, potency, or safety. [3]

When manufacturers claim the effectiveness of their supplements, those claims are often based on observational studies — weak science that doesn’t follow the scientific method. [4]

The scientific method uses randomized controlled trials (RCT). RCT participants are randomly split into a research group (that gets the actual drug) and a control group (that is given a placebo, e.g. a sugar pill). This demonstrates the effectiveness of a substance versus not using it.

Three RCTs of daily multivitamins found they made no difference to overall health, despite observational studies saying they did make a difference. [5]

Bioavailability

When we digest, we don’t always absorb all the nutrients from our food. Some foods are more difficult to digest than others, which determines the bioavailability of nutrients in everything we eat.

Mother Nature helps us out here by naturally including co-factors and enzymes in the food we eat that help us absorb as many of the nutrients as possible — little food concierges that help the nutrients into our bodies where they’re supposed to go. [4]

Without the co-factors and enzymes, the nutrients in supplements are much less bioavailable. This means we’re pooping out the value of the supplement. [6]

Natural vitamin E, for example, absorbs twice as efficiently as supplement vitamin E. Vitamin C is about the same efficiency in natural versus supplement. [7,8]

The coating and capsules of supplements often negatively impact supplement bioavailability as well. [4]

Interactions

Most supplements won’t hurt but some have harmful interactions, for example: [9]

Vitamin K reduces the effectiveness of blood thinners
St. John’s wort makes antidepressants and birth control less effective
Vitamin A increases the risk of lung cancer in smokers

Some supplements also work against each other. Calcium can block iron absorption.

So overdoing it could cancel everything out. [10]

What actually works

Fortification

We only need a small amount of each vitamin and mineral. The FDA helps us out here by mandating the fortification of foods. By doing so, government agencies have reduced illnesses caused by not getting enough vitamins and minerals.

In the 90’s, the FDA mandated folic acid be added to wheat products which vastly reduced birth defects. [3]

When milk commercials brag that they added vitamin D to the milk? It’s because the government told them to.

Placebos

If you feel a supplement is working for you – it could be the placebo effect working in your favor.

The placebo effect is when you feel as though something is helping despite it not biologically working. [11]

Placebos don’t cause physical changes in your body but can impact symptoms or effects modulated by the brain, like pain or nausea. [15]

Our minds are that powerful.

Select well-studied supplements

Some supplements have been well-researched and are beneficial in certain situations:

· Vitamin D: bone strength in seniors

· Vitamin B12: vegans and vegetarians

· Folic acid: pregnant individuals

· Any supplement: if directed by a doctor based on bloodwork showing deficiency

How to choose supplements

A product analysis of 30 immune vitamins from Amazon showed only 13 were accurately labeled. It’s important to be sure of what you’re getting. [12]

The FDA won’t help here, but you can look for certain seals on your supplements that show they’ve been monitored by independent agencies. Here are a few of the big ones: [13]:

CVS also commits to only selling third-party tested supplements that pass their relatively strong guidelines. [14]

Recap

The background on supplements:

They aren’t regulated like pharmaceuticals
They don’t always have the same bioavailability as nutrients in whole foods
They interact with other drugs and supplements

What works:

The FDA mandating food fortification to help us get all our nutrients
The placebo effect
Select, well-studied supplements in specific situations

How to select good supplements:

Look for products with seals from NSF International or UL
Shop exclusively at CVS for supplements

Now here’s a list of all the vitamins and supplements you need — consider the column on the right your shopping list.

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