To supplement, or not?

Perhaps a few times a week I’ll get asked about vitamins and dietary supplements from my friends, family members and patients alike. People are always looking for a “natural” way to take care of their health and getting to be a part of these discussions has been a rewarding experience for everyone involved. From questions about whether Vitamin C really shortens a cold (it doesn’t), to taking biotin for hair and nail growth (just eat eggs and nuts), let’s sift through all the advertising to get to what really works. About a month ago I was reading a magazine article about a lounge in NYC that offers intravenous vitamin therapy. There is a menu of “treatments” you can receive, including a 60-minute infusion of a variety of minerals and vitamins, all while you hang out in a spa like environment.  While I was already rolling my eyes with each passing sentence, what really caused me to cringe were the claims of “a boost of energy right away with benefits that would come in waves throughout the week.” With all the information that is readily available to every consumer, it’s vital that we understand what we’re actually putting into our bodies and whether it’s even necessary.

When it comes to supplementing your diet with “natural” herbal remedies or “natural” vitamins, I think it’s important to remember that the most natural way to achieve that is through your diet- not supplementing with pills and definitely not with an IV treatment at a fancy lounge. Many vitamins and nutrients can be found over the counter these days, but taking too much of either can actually cause harm. In addition, what many people don’t realize is that over the counter supplements are not regulated by the FDA. While medications go through a lengthy approval process before they can be sold to the public, supplements are not. I had a patient who was taking an energy drink she found at her local convenience store and presented to the hospital with kidney failure. Everything you ingest, however unassuming, can have consequences to your health. Nausea, vomiting, confusion, kidney stones, and constipation- these are just a start to the constellation of symptoms that occur with overuse of vitamins and minerals, even with something as simple as calcium or iron. Like anything in life, moderation is key and if you’re getting enough meats and veggies in your diet, then you’re also getting all the nutrients you need.

Vitamin and mineral deficiencies can cause real health problems though, from neuropathies to bleeding disorders to bone disease. If you do go to your doctor and find that you have a deficiency, then taking the supplement is necessary. I once took care of a patient who was originally from a developing nation that had been devastated by an earthquake. She came to us with progressive weakness until she had completely lost her ability to walk. When asked about her circumstances, she admitted for months she had no access to meat.   Her cyanocobalamin (Vit B-12) levels were nearly undetectable. She is the type of person that giving a B-12 shot to would actually make a difference. Otherwise, B-12 can be found in animal products, including eggs and dairy, and is stored in the body for years. So for those of you who eat meat daily and request B-12 shots, there really is no need.

That being said, there is a role for prophylactic (for prevention) supplementation and even those that provide the “placebo-effect”. There are times when supplementing your diet with vitamins and minerals is absolutely imperative. During pregnancy taking folic acid can prevent neural tube defects in children. Vitamin D in the elderly can help prevent falls, and there are studies being conducted to see the role it can play in diseases like multiple sclerosis and different cancers. Although there have been no studies to prove that chondroitin or glucosamine help with osteoarthritis, there are patients who find relief taking them and that’s okay too. The first rule to remember is: Do no harm.   Each situation and individual is different, and discussing what helps and harms with your physician is key.

With the scrutiny people pay to things like food and vaccines, it doesn’t make sense to not apply that same level of curiosity to the additional supplements that are on the market. Taking supplements can mask other deficiencies and even decrease the efficacy of medications you may already be prescribed for other conditions.  Even if you aren’t taking medications for chronic conditions, at some point you may need a short course of antibiotics and there are supplements that can affect the metabolism there too. Herbal remedies like gingko biloba, St. John’s Wort, black cohosh, and ginseng are just a few popular home antidotes that can disrupt the life saving medications you need to be on. Before taking any supplements no matter how natural they may appear always discuss with your physician if it is something you should take, or in many cases, even need to.