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July 6, 2018

Q & A on Supplements and Vitamins

Q & A on Supplements and Vitamins

By Dr. Jenifer Johnson, Family and Internal Medicine

So many supplements and vitamins are available out there that it is virtually impossible for the consumer to figure out what is safe, and what he/she should or shouldn’t take.  If you’re convinced that a supplement or vitamin will benefit you, it is best to discuss it with your physician first, especially if you are being treated for any medical conditions.

What are the pros and cons of taking supplements in general?

The advantages are that if your body is deficient in a particular nutrient or vitamin– either due to decreased absorption or dietary deficiency–a supplement might be an easy way to fill that deficiency without major dietary or lifestyle change. In some cases, patients are looking for a specific positive effect, like firmer skin or stronger nails, that a supplement has been touting. Disadvantages are that the FDA does not have the authority to review dietary supplement products for safety and effectiveness before they are marketed, nor do these products tend to be studied in a systematic fashion. Therefore, there is no guarantee they are effective or nontoxic.  This can lead to wasting money (best case scenario) or harm to your health (worst case scenario.)

How can you assess if you are actually lacking in nutrients that could impact your appearance?

Is a blood test the answer? Most nutrient levels fluctuate widely based on dietary intake in the previous days or weeks, and there is little standardization in “normal levels” so blood tests are not terribly reliable except in a few common cases like vitamin B12, Vitamin D and iron. Standard blood tests would detect anemia, which would be the most common consequence of B12 or iron deficiency. Unfortunately, physical appearance alone (other than very dramatic examples of chronic malnutrition) rarely clue us in to subtle nutrient deficiencies.

How can you size up a supplement to figure out if it’s made well or contains nutrients that will be absorbed? You can’t really. That is the issue. As a general rule, if it sounds too good to be true, it likely is.

It would seem that eating a good diet is always best, but that’s not always easy or affordable (fresh produce is expensive, busy/working people don’t always have time to cook). In this case, do you feel supplements can play a role? Or do you recommend any other alternatives?

Eating healthy is the best way for your body to absorb nutrients. If your diet is completely devoid of fruits and vegetables, I would suggest a multivitamin to replace nutrients you may not be getting. Otherwise, we have very little data, if any, that people eating a reasonable and varied diet get additional benefit from supplements. I would rather see people invest the time/energy into improving their diet than try to find it all in a pill.

What’s the risk of taking too much of any vitamin? Is that a real concern here?

Most water-soluble vitamins will just be excreted harmlessly in the urine. However, certain fat soluble vitamins (A, D, E, and K) can build up in the tissues and cause real toxicity. I advise against taking more than the daily recommended amount of these vitamins without consulting with a physician. Certain metals, like iron, can also build up in body tissues creating specific disease processes. It’s also best to consult with a physician before taking any supplement long term. Finally, supplements could interfere with other prescription medicines, or cause unintended side effects like bleeding. Even “harmless” things like fish oil can have this effect, which could be especially pertinent if you need surgery.

Do you need to discuss taking a supplement or vitamin with your doctor? A list of Westmed’s primary care physicians and contact information is available here.