We believe that food is always first. Natural wholefoods are so much more than the sum of their parts and eating them should be one of life’s pleasures. However, evidence unfortunately shows the decline in nutrient levels in our food over the last 50 – 100 years. This means that it’s even more important than before to squeeze many nutritious wholefoods into our daily diet. It also means that some of us may benefit from the use of supplements. This can be in the shorter term as we work on dietary change.
Research around supplements is confusing!
The research on the benefits of supplements is a mixed bag. Some studies show positive results and others show no benefit or even negative results. Why do we see such a huge variance? If we leave aside the fact that proper clinical trials cost a lot of money and not many organisations have the resources or financial incentive to run these trials, what else is going on?
Let’s talk about bio-availability
Firstly, many studies use different forms of nutrients and we know that these are not all created equal. For example, calcium carbonate, the form of calcium found in many bone health supplements and used in most trials is less easily absorbed, or in technical terms, less bio-available, than calcium citrate and some other forms of calcium. Study headlines don’t usually take this into account. Also, the huge number of supplements available make it difficult to know which one is best. We carefully chose the supplements we recommend for high bio-availability and avoid products with unnecessary fillers, binders and additives, which can cause reactions in some people.
We all have different requirements
An even bigger challenge is the fact that individual baseline levels of nutrients are not usually checked at the beginning of a study. If you are deficient in a nutrient, it stands to reason that you will see a benefit from restoring your levels. This is particularly true if a deficiency of that nutrient is related to your symptom or health condition. However, if you already have enough, then adding even more is unlikely to be of benefit and could be detrimental. For example, if you are feeling tired or breathless and find that you are low in iron, you should feel better taking a good (bioavailable 😊) iron supplement. If your iron studies are normal, then supplementing iron is of no benefit. Indeed, you might even find that you have too much iron (haemochromatosis), which very confusingly can also cause fatigue.
Too many supplements is as bad as too little
We have seen countless instances of patients supplementing single nutrients who have actually had raised levels of that nutrient when checked. A recent example was a male fertility patient who had been supplementing selenium for 7 months. This was based on research he had read on the importance of selenium for male fertility. His levels of selenium were raised however. This excess can have a negative effect on sperm and other aspects of health. That’s why in clinic we usually test before recommending single nutrients. If you want to find out more about nutrient levels in relation to fertility, you may be interested in this podcast with our own Dr Ciara Wright PhD.
How much is enough?
There are some vital nutrients that we know are low in many people in Ireland. These include vitamin D and omega 3. We may recommend supplementation of these even before testing, based on a review of dietary or medical history. But it is always better to check, as standard supplementation may not be enough to correct a deficiency. A recent patient seeing us for osteoporosis had levels of vitamin D 90% below the reference range. Using a standard level of vitamin D supplementation would not have restored her levels. Also, persistently low vitamin D would likely have had a detrimental effect on her bone health.
If possible, check
So, where you can, we recommend checking your nutrient levels. Your GP can check iron, B12, folate and in some cases vitamin D. We are delighted that we are still able to offer our Functional Nutritional Profile and other Functional Medicine tests to our patients and please get in touch if you need any additional information. If you can’t test and don’t have an underlying medical condition or are not taking any medication that affects your nutrient levels, then avoid single nutrients and stick with a multivitamin.
If you would like more information about the services we offer, including testing, please get in touch.