Should you take a dietary supplement?

The lack of hard scientific data on many supplements makes it hard to give specific recommendations. There are many claims on the internet, and it's hard to separate truth from marketing. Overcoming information overload is the core goal of this library — this section reviews supplements, links to trustworthy sources, and helps you decide what may be best for you.

Let's start with a few basic concepts

Macronutrients are the caloric fuel you need for daily energy — the building blocks of tissue, fiber for microbiota, cholesterol for hormone production. We know them as carbohydrates, fat, and protein.

Micronutrients — the focus of this section — are the vitamins, minerals, and phytonutrients your body needs in smaller amounts. They contribute to hormone production, brain function, and immune function.

Dietary supplements are a key component of many wellness routines. Just look in your medicine cabinet and count the random bottles you've accumulated. Half have probably expired, and you've forgotten what the others were for.

The Recommended Dietary Allowances (RDA) for vitamins and minerals have been the same since the early 1940s. A bit outdated. Nutrition researchers today generally agree that the RDAs fall far short when it comes to preventing chronic disease, promoting vitality, and supporting longevity.

Vitamin and mineral insufficiencies could be the cause of — or a contributing factor to — many of the health issues we deal with today, including depression and anxiety.

Why do we take supplements in the first place?

Because we believe we need them. Someone we trust swears by a product, or we read about a supplement in a magazine, saw a commercial, or a slick social ad. (Don't feel bad — it happens to all of us.) Consider the source. Taking a supplement without fully understanding the risks can be detrimental to your health.

Supplements can be a great way to boost nutrition, and depending on your diet, lifestyle, and stage of life some will have advantages over others. Choosing the right ones is often overwhelming — hundreds of options, hundreds of internet sales pages full of confusing and conflicting information.

By the numbers

• 9 out of 10 people have some sort of nutritional deficiency
• 73% of supplement users take a multivitamin
• Two-thirds of Americans take dietary supplements every day
• 8 out of 10 physicians recommend supplements to their patients
• 85% of seniors 65+ take supplements

What are supplements?

Dietary supplements include the 13 vitamins and 16 minerals your body requires to function properly. They also include herbs, essential oils, botanicals, amino acids, enzymes, and many other products. Some — specifically vitamins and minerals — fill nutritional gaps; others promote health or weight loss.

Scientific evidence shows that some supplements are beneficial for overall health and for managing certain conditions. Calcium and vitamin D, for example, help keep bones strong and reduce bone loss. Omega-3 fatty acids from fish oil may be beneficial for heart disease and brain function.

Herbs like echinacea, essential oils, specialty products like glucosamine and probiotics, and weight-loss supplements such as whey protein and energy bars need more scientific study to determine their value. There is, however, plenty of anecdotal evidence. Herbs, essential oils, and botanicals have been used for hundreds of years in Eastern medicine. Regulations ensure that herbal supplements meet manufacturing standards but don't guarantee they're safe or effective. Do your homework before you buy.

Where do supplements show up in your life?

Probably everywhere. Detox tea, a protein shake at breakfast, ashwagandha tea in the afternoon. Supplements come as pills, powders, drinks, shakes, bars, essential oils, balms, meal replacements — and more recently in liquid form taken with a dropper.

What to consider before you take supplements

Consult your physician first. Most of us don't realize that self-prescribing over-the-counter supplements can throw the body relatively off balance. Vitamins are most effective when tailored to fill gaps in your diet or reach specific health goals. Many physicians recommend blood tests to find deficiencies before recommending supplements. You're different from everyone else — your supplements should be too.

Other things to consider

• Medications — some supplements can react adversely with prescriptions.
• Diet — if you follow a vegan or elimination diet, monitor levels of nutrients like vitamin B12.
• Lifestyle — unmanaged stress and inadequate sleep push many people to supplements. Address the root cause first with daily self-care.
• Exercise — athletes may benefit from certain supplementation, but consult a doctor or sports nutritionist first.

Lab tests: a true measure of your overall health

No supplement makes up for a poor diet, lack of exercise, high stress, and inadequate sleep. If you don't eat a nutritious variety of foods, some supplements might help you get adequate essential nutrients. But how do you know your current levels? You don't — until you test. Lab tests provide bio-markers so you know what you're working with, and can address your body's needs with the science behind targeted supplementation.

What types of lab tests are there?

Your physician can order many, and reputable companies mail do-it-yourself kits. A Basic Nutritional Panel measures a combination of vitamins, minerals, and antioxidants and typically includes:

• Complete Blood Count (CBC)
• Comprehensive Metabolic Panel (CMP)
• Iron and Total Iron Binding Capacity (TIBC)
• Vitamin B12 (Cobalamin)
• Vitamin D
• Vitamin C

Thyroid function

Weight gain, fatigue, and brain fog — symptoms many women suffer from and often try to fix with herbal supplements — can also be indications of hypothyroidism, in which the thyroid slows or stops making thyroxine. Women are 2 to 10 times more likely than men to develop thyroid conditions, which are medical and require professional treatment. A 2013 study in Thyroid found nine out of ten supplements marketed for thyroid health contained actual thyroid hormones. Get a thyroid panel first (T3, T3RU, T4, T7, and TSH) before self-treating.

Blood sugar & prediabetes screening

Knowing if you have sugar imbalances or are prediabetic matters. Fasting glucose is the most common test, but it's typically used diagnostically rather than for prevention. A healthy diet, physical activity, and maintaining a healthy weight are the most important parts of diabetes prevention. Supplements may help with weight — but there's no evidence herbal or botanical supplements can control blood sugar or reverse diabetes. If it sounds too good to be true, it is.

Inflammation

Inflammation is your body's process of fighting infections, injuries, and toxins. Chronic inflammation — thought to be the cause of many chronic and degenerative diseases — is when that natural response doesn't turn off. Common symptoms include fatigue, fever, mouth sores, rashes, and abdominal or chest pain.

Cholesterol

A Fasting Lipoprotein Profile measures total cholesterol, LDL (bad), and HDL (good). Every four to six years is typical — more often if you're at increased risk for heart disease or stroke.

Quality matters

There's a real difference between high-quality supplements and what you pick up at the supermarket. Your results depend on the quality of what you take.

1. You get what you expect. Reports have shown products don't always contain the ingredients advertised on the label. Quality products are tested and given a seal of approval.
2. Correct dosage matters. Too little and it may have no effect. Too much and it could be harmful.
3. No unwanted extras. Trust that your supplement doesn't contain heavy metals, pesticides, mold or mildew, or pharmaceuticals — and that the ingredients are actually absorbed.

Supplement companies and MLMs

Let me start by saying: I'm not anti-MLM, and I'm no stranger to them. I've been certified with Optavia, occasionally buy Melaleuca, and use products from Purehaven, Beachbody, and doTERRA essential oils. I get it.

Most Health & Wellness MLMs are genuine and trying to do the right thing. It's exciting that health and wellness is a topic of conversation. They're popular because there's real demand — we're more interested in our health, and honestly, we're looking for the easiest ways to improve it. That's where these supplements fit. We want a quick fix, and MLMs deliver — literally to your front door.

It's a lot easier to open a pouch, add water, and shake than to gather a dozen ingredients, chop, measure, blend, drink, and wash the blender.

Product testing and transparency matter. Does the company provide research? Are products third-party tested? Do your due diligence. In my experience, initial product education for independent reps is often lacking — the focus is on selling product and growing a team. Ask lots of questions, read the research, and talk to the scientists. A reputable company will make research readily available.

Safety and risk

Many supplements contain active ingredients that can have strong effects in the body. Always watch for unexpected side effects, especially when starting a new product. Side effects are more likely when supplements are taken in lieu of prescribed medication, or when several are combined. Some interactions can increase bleeding risk — take supplements only as directed.

Three key things to know

• Sourcing — are the ingredients natural or synthetic? Whole-food sources tend to deliver more nutrition.
• Absorption — fast-acting or slow-release? Steady delivery is often healthier than a rush-and-crash.
• Manufacturing — the FDA doesn't review supplements before market. Companies only need to follow CGMP guidelines. Reputable companies opt in to voluntary third-party certification.

Independent quality testing

• ConsumerLab.com
• NSF Certification
• U.S. Pharmacopeia

Additional resources & reading

• How to read a supplement label
• The most commonly overlooked lab tests — Dr. Karen Wolfe
• Dr. Karen Wolfe — supplements articles
• NIH ODS — Dietary supplements: what you need to know
• Stop the Thyroid Madness
• Measuring an anti-inflammatory diet — Karen Collins Nutrition
• MedlinePlus — C-reactive protein (CRP) test
• PBS Frontline — Supplements and Safety (transcript)