May. 5. 2016
Truth
McKel Hill

McKel Hill

MS, RDN, LDN, Dietitian

One of the most highly requested blog posts have been about answering this question: should I take supplements? Well, let’s dive in! Oddly enough, I really enjoy speaking about and researching supplements, and to give you a little background, my graduate thesis investigated fellow registered dietitians’ and dietetic technicians’ knowledge on supplementation. It was fascinating and eye-opening just how little knowledge is out there about supplements, although in the past five years there have definitely been improvements. So why is this important? Americans will spend $21 billion on vitamin, mineral, and herbal supplements in a year (1). Bookmark or share this blog post if you’re curious about supplements, vitamin deficiency and what to do about it, and what supplements to take for better health and a balanced wellbeing.

First off, let’s break down the word supplement. A supplement should do just that, SUPPLEMENT your existing healthy diet and lifestyle. Supplements are needed to boost health during times of stress, illness, or to treat deficient vitamin/mineral states. Other than that, limit supplement use. The supplement industry, as noted above, is huge! The downside with this large of an industry is the lack of oversight and regulation. The FDA states the following regarding supplement regulation (and in a nutshell, you can see how there is a lot of room for bad products to get in the industry):

  • Federal law requires that every dietary supplement be labeled as such, either with the term “dietary supplement” or with a term that substitutes a description of the product’s dietary ingredient(s) for the word “dietary” (e.g., “herbal supplement” or “calcium supplement”).
  • Federal law does not require dietary supplements to be proven safe to FDA’s satisfaction before they are marketed.
  • For most claims made in the labeling of dietary supplements, the law does not require the manufacturer or seller to prove to FDA’s satisfaction that the claim is accurate or truthful before it appears on the product.
  • In general, FDA’s role with a dietary supplement product begins after the product enters the marketplace. That is usually the agency’s first opportunity to take action against a product that presents a significant or unreasonable risk of illness or injury, or that is otherwise adulterated or misbranded.
  • Dietary supplement advertising, including ads broadcast on radio and television, falls under the jurisdiction of the Federal Trade Commission.
  • Once a dietary supplement is on the market, FDA has certain safety monitoring responsibilities. These include monitoring mandatory reporting of serious adverse events by dietary supplement firms and voluntary adverse event reporting by consumers and health care professionals. As its resources permit, FDA also reviews product labels and other product information, such as package inserts, accompanying literature, and Internet promotion.
  • Dietary supplement firms must report to FDA any serious adverse events that are reported to them by consumers or health care professionals.
  • Dietary supplement manufacturers do not have to get the agency’s approval before producing or selling these products.
  • It is not legal to market a dietary supplement product as a treatment or cure for a specific disease, or to alleviate the symptoms of a disease.
  • There are limitations to FDA oversight of claims in dietary supplement labeling. For example, FDA reviews substantiation for claims as resources permit.

To find a list of reputable supplement brands I use and recommend to clients, check out the list and resources at the bottom of this blog post to help you find what’s best for you. A note to keep in mind, everyone is different and their supplement usage and dosage will be dependent on their lifestyle, goals, metabolism, and overall current health state. Always check with your registered dietitian or physician for specifics.

ARE YOU DEFICIENT? Probably not, but maybe? We live in a modern world with amazing advancements in technology yet our soil suffers and lacks minerals that it once did causing whatever grows out of it (i.e. fruits, vegetables and whole food) to be devoid of nutrition or at least significantly lower in minerals than it once was. Not only is our soil different, but our food takes a long time to get to us! Unless we’re growing our own whole food in our gardens, picking it out with our bare hands and washing it off before eating- then most likely it’s been picked weeks before it reaches your grocery store, then is purchased by you. This entire process can take weeks and cause nutrients to be depleted from the whole food (2). Check out these signs and symptoms of the most common mineral and vitamin deficiencies which are still not that common in our modern age of advanced medicine and better nutrition education.

Zinc: low immune function (getting ill quite often), dry skin, brittle hair and nails, white lines in nails, very slow wound healing, hormonal imbalance, past diagnosis or history with H. pylori, sluggish thyroid/possibly subclinical hypothyroidism.

  • Who may be prone to this deficiency? Athletes who sweat a lot, vegans/vegetarians, those with malabsorption issues, celiac/gluten sensitivity, high stress (both mental and physical), trauma/serious illness and health issues, and overall low nutrient/energy intake.

Iodine: sluggish thyroid, subclinical or clinical hypothyroidism, slow metabolism (i.e. difficult to lose weight despite conscious diet changes and exercise routines), goiter.

  • Who may be prone to this deficiency? This is not very common unless you avoid table salt, processed foods with added iodine, or rarely eat seaweeds/seafood which are potent sources of iodine. Since our body relies on external iodine, we must meet this need through our diet

Iron: dry skin, brittle hair and nails, pale-ish skin and tongue, low immune function, general fatigue/weakness, irregular heartbeat, shortness of breath, headaches, tingling in hands/feet.

  • Who may be prone to this deficiency? Vegans/vegetarians, poor diet intake (both in quality and quantity), pregnant women, those who have internal bleeding, some illnesses, premature babies.

Magnesium: leg cramps, headaches/migraines, mood swings, loss of appetite, nausea, vomiting, fatigue, numbness, tingling, seizures, personality changes, abnormal heart rhythms, and coronary spasms can occur if severe.

  • Who may be prone to this deficiency? Athletes, those with poor diets, those not eating mineral rich diets as a whole, alcohol dependency, those with type II diabetes, those with digestive issues/disease, and older individuals. 

Vitamin D: low energy, hormonal imbalance, increased risk for serious diseases, associated with higher risk of cancer, cardiovascular disease, osteoarthritis, and autoimmune disorders like multiple sclerosis, type 1 diabetes, depression, and more.

  • Who may be prone to this deficiency? Those who avoid sun, live in Northern hemispheres, vegans/vegetarians, obese individuals, darker skin tones, and older individuals. 

B12: sluggish energy, lethargy, tingling in feet/hands, Alzheimer’s, dementia, cognitive decline and memory loss, multiple sclerosis (MS) and other neurological disorders, depression, anxiety, bipolar disorder, psychosis, cardiovascular disease, learning or developmental disorders in kids, cancer, infertility.

  • Who may be prone to this deficiency? Most common amongst vegans and vegetarians who don’t consume animal products or are limited in their diet. If someone on a vegan dogma diet preaches that you don’t need to take B12, they have no idea what they’re talking about! B12 is ESSENTIAL and chronic deficiency can result in sometimes irreversible neurological damage, it’s not something to play around with, folks.

So how do you find out if you’re deficient? First things first, have a great relationship with your physician, you are THE best health advocate for yourself and know when something feels “off”. Listen to your body and enlist the help of your physician to go over blood tests and further physician recommended tests. Keep this in mind: I see this time and time again (and even personally) – your feelings, your symptoms, and intuition plays a huge role here. For example, I’ve seen many women clients who on paper have “normal” ranges for thyroid, yet after we take a nutrition intervention approach to improving their thyroid, their symptoms disappear and they “feel” like themselves again. This is the golden nugget. Always use science, numbers, and blood work as your backbone, but listen to your body as well and always be your own health advocate since you know your body like no one else! Okay, off my soapbox.

Besides treating and addressing nutrient deficiencies, there are other opportunities to boost general health with the following supplements I recommend that (most) people can incorporate. Also be aware of the fine line of consuming too much of a good thing; this is definitely the case with supplements. Be smart, always ask your physician or registered dietitian to make sure you’re consuming the goldilocks amount and not excessively taking in vitamins/minerals you don’t need which can lead to more serious health issues like cancer, heart disease, liver toxicity, etc. (3)(4)

Resources I use for supplements research and/or brands I recommend:

Still have questions about what supplements you should be taking? As always, consult your physician before taking any new supplements or your certified nutrition professional/dietitian that you’re closely working with. If this is something you’d like to dive a little deeper in, consider becoming one of my clients by signing up here.

xx McKel

Resources: 
(1): http://annals.org/article.aspx?articleid=1789253
(2): Davis, D.R. (2009) ‘Declining fruit and vegetable nutrient composition: What is the evidence?’, HortScience, 44(1), pp. 15–19
(3): Nasr, S.H., Kashtanova, Y., Levchuk, V. and Markowitz, G.S. (2006) ‘Secondary oxalosis due to excess vitamin C intake’, Kidney International, 70(10), pp. 1672–1672.