Let’s discuss dietary supplements pros and cons as not all supplements are created equal. Going out and buying a multi-vitamin/mineral combination that gives you 100% or more the RDA of everything is not necessarily a good idea. Don’t think that if you don’t need it, your body won’t use it, or you’ll just “pee it out.” Supplements, when appropriately taken and in their correct form, have the ability to make powerful beneficial biochemical changes within your body. If they can have such positive effects, they can surely have negative effects too. Supplements can cause harm, yet we rarely hear about this other than the child who accidentally got into his mother’s iron tablets. At the cellular level, taking the wrong nutrient, or, even worse, not knowing what you are taking, may cause damage in the long run.
Today, the two most common nutrient overdoses we see clinically are from vitamin E and calcium. This is mostly in women because they’re told these nutrients will help their bones and their hormones. Though they may in some people, calcium doses over 1000mg a day especially in the poorly absorbed carbonate form and vitamin E over 400IU a day especially in the synthetic dl-alpha tocopherol form cause a lot of people a lot of problems. And they never make the connection. I have seen women with terrible back pain taking high doses of calcium only to cut the calcium down and the back pain goes away. (This is an example; I’m not advising you to stop your calcium if you have back pain.)
Additionally, taking a multi raises your level of all nutrients within that supplement (considering you can actually absorb and assimilate them). This is like paving over an old road without filling in any of the potholes. The balance of nutrients is many times more important, unless there is gross malnutrition.
There are many types of the same supplement. For example, there is zinc carbonate, zinc picolinate, zinc glucurate, zinc citrate, and other forms. While one person may benefit from one type of zinc, another may need a different form. Similarly, there are many forms of some nutrients. Take, for example, vitamin B1. B1, (thiamine) is converted to thiamine monophosphate which is converted to thiamine pyrophosphate which is then ultimately converted to thiamine triphosphate. If things aren’t working properly you can’t make the conversion and the B1 supplement will do you no good. This is especially true for folic acid. The typical folic acid must be converted into folinic acid then into methylene tetrahydrofolate then finally into 5-methyl-tetrahydrofolate. It’s estimated that over 40% of people can’t do that genetically, and many more lack the nutrient cofactors to make the conversions. This is such an essential nutrient, especially for pregnant women; it’s not something just to guess at.
Dietary Supplements Ingredients
Then, we’ve got all the other stuff companies put in supplements. Since March 23, 1999, dietary supplement companies have had to adhere to stricter guidelines regarding their labels. This lets the consumer know what is in their supplement, including any binders, lubricants, coatings, colorings, and fillings. Unfortunately, they do not have to tell you exactly what is in the supplement unless the substance was added in the final dosage form. In other words, since there is more than one step a manufacturer uses when making a supplement, they do not have to disclose where a particular substance came from, or what is was mixed with, unless it was used in the final product.
Two product labels can look exactly alike, until you break them down to examine how they were really made. A product will typically say the words “hypoallergenic,” which means non-allergy producing. It may go on to say that it is free of corn, wheat, dairy, yeast, etc. However, these same products may have cornstarch, lactose (dairy), and other allergenic substances. They just weren’t put in there directly. Natural vegetable coating, natural protein coating, maize protein, are all forms of corn, which many people are allergic to.
Dietary Supplement Absorption
Absorption is a major factor in supplements. If you take them, and don’t absorb them, then there really is no point. Yet most supplements contain lubricants made of indigestible ingredients that prevent you from absorbing the active nutrient(s). The point of lubricants is to help the processing machines run more efficiently, yet you will run less efficiently. Lubricants include stearic acid, magnesium stearate, calcium stearate, fractionated vegetable oil, hydrogenated vegetable oil, castor oil, and ascorbyl palmitate. Many times the company will make it sound like they’re doing you a favor by saying that the ascorbyl palmitate is a “vitamin C source,” or the calcium stearate is “a source of calcium.”
Like food, you get what you pay for when it comes to supplements. We know that there is a difference between eating fish at Burger King and from eating at a restaurant where the fish actually have a name, like salmon, or cod, or tuna. You would most likely be too timid to order a piece of steak for $4.99 and get the second one for just a penny.
Then there is the “Timed-Release” factor that customers love. Shouldn’t our food be timed released then too? A good supplement will be absorbed where it needs to be absorbed. Nutrients are not meant to be absorbed slowly as they trickle through your digestive tract. Consider niacin. In its timed-release form, it can cause elevated liver enzymes and liver damage. That’s not too cost effective.
I don’t want to scare you away from supplements. I use them a lot and see extraordinary health changes take place with them. But there are a lot of claims out there that aren’t true, and too many physicians and non-physicians prescribing supplements that they have no right prescribing.
Hi Dr. Gangemi,
I was wondering if you have ever treated a patient that used any products from Woman to Woman? They have a web site with products that claim they can help balance your hormones. They also have a multivitamin and a Omega 3 product.
I have not; I don’t think I’ve heard of that company.
I have two questions about supplements. First, do you think it is OK to take in powered proteins after working out (or when eating a meal isn’t feasible)? Second, and slightly off topic, do you feel Stevia is a safe sugar substitute? I prefer Purevia (trade name) but was wondering if you felt it was harmful. I have no doubt that adding nothing to my tea would be better, but my sweet tooth is a hard habit to break. I am weaning myself off of Diet Coke as well. Thank you!!!
Yes on the protein – see the “excitotoxin” article though on this site.
No on the Stevia – it’s processed and still triggers your body to shift to sugar-burning.
What supplements do you recommend (brand)? When kids have allergies? Is the cause the actual allergen or a low immunity which cause you to get sick and possible allergy? What supplement should kids take? What is the safest omega 3 to ingest? coconut oil flax oil, etc?
That’s all very individualized. I have dozens of supplement companies I use.
Could you share that list?
Rubyr Rodrigues says
My daughter, 25 years, has been diagnosed with gallstones 11mm & multiple smaller ones, she also has constipation & gall stones attack. What would be the best line of treatment.
Dr. Stephen Gangemi says
Check out the 2 gallbladder articles on this site for some guidance.
GWENDOLYN J REVERMAN says
My Dr. told me I have large red blood cells and to take vit b12 and folic acid. I tried to take just a fraction of a sublingual tablet because I am very sensitive. It made me dizzy and my blood pressure went really high. What do you suggest I try? Thanks, Gwen
Dr. Stephen Gangemi says
Sorry I can’t give personal advice without seeing you. :)