Sunday, July 22, 2018

Supplements - what you need and why you need them.

Every day I see patients who are confused about supplements. I understand - I've gone shopping for supplements and have been confused about what to get and whether to believe the claims about their benefits. I am an IFM certified practitioner and being a Functional doctor means helping people improve the way their bodies function.

The Good Lord gave us everything we need to be at our best health but the society we live in today isn't conducive to being healthy. This shows up in our bodies as our increasingly stressful livestyles and our increasingly nutrient deficient eating habits cause our bodies to become DIS-eased. As we age this process accelerates because our bodies can't repair the damage at the pace that we are creating it inside our cells.


This is what I have in my kitchen today to eat (plus a bodacious double chocolate zucchini bread - gluten free and vegan of course). I bought a share of an organic farm and my CSA share contained all of this except the cherries that I got (organic) at Whole Foods and the avocados purchased at Sprouts.

Even if I only eat organic produce and pastured meat, the nutrient density in our food supply is deficient due to the land being over used. I'm pretty sure I'm getting more nutrients from this family-owned organic farm than from the food at the grocery store but I still take supplements.

So I'm going to cover the Top 5 supplements that I think most Americans eating a 'Standard American Diet' need to improve their health. First, many people try to cut corners and buy supplements from a club or service or even at Target or Walmart or GNC but since supplements aren't regulated, these larger merchants get their supplements from the lowest priced options which are usually sourced from China and other areas that don't screen the ingredients for purity.

Another worrisome issue is that many of these cheaper supplements don't even have the ingredients on the label! When the Attorney General in New York State chose random supplements from the above mentioned merchants, over 75% of them did not have the listed ingredients. Some were labeled gluten free and actually contained gluten! The third problem with cheap supplements is that the amount of ingredients is usually far below what you need to improve your health.

One example I can think of is when a patient proudly told me she took fish oil daily and then produced the bottle and the total omega 3 content was less than 500mg. This means the EPA and DHA (most useful omega 3s) added up to less than 300mg. I usually recommend AT LEAST 1000mg of combined EPA and DHA so she was getting less than a third of my minimum recommended dose. She was paying about half of what a quality supplement with over 1000mg would cost but she was only getting about a fourth of the benefit. Note on my bottle the 'NSF' quality seal and the listing of the actual amounts of the EPA and DHA components of the omega 3 content in the image below.


So fish oil is a very important supplement. The EPA fraction is very anti-inflammatory and can help with heart health. The DHA fraction is also anti-inflammatory and helps with brain health. The other omega 3 fatty acids are all anti-inflammatory and help with hair, skin, eyes, and all of them together have been studied and found to help with ADHD, arthritis and to inhibit certain cancers from growing. To list all their benefits is beyond the scope of this one post so I will just say that a high quality, screened for purity and sourced from reliable and sustainable sources Fish Oil supplement is usually the first supplement I recommend to patients.

Omega 3 fatty acids are found in cold water fish like salmon and sardines and anchovies but I doubt many of us eat enough of these foods regularly to see the benefits of adequate omega 3 intake. It is thought that historically humans ate a diet that was balanced with a one to one ratio of omega 3s to omega 6 fatty acids and now, due to the proliferation of processed foods containing high amounts of omega 6s, that ratio is close to 20:1 or higher in favor of omega 6s (which, by the way, can be very inflammatory). So for most people, taking a supplement is the best way to improve their ratio of omega 3 fatty acids to the omega 6s.

My second most frequently recommended supplement is a really good multivitamin. Since we see all sorts of chronic disease issues at my clinic, we have multiple options to offer patients. There are special vitamins targeted for specific patients (like prenatals) but in general, I like a vitamin with methylated folate and B12 (because a significant percent of the population has difficulty with methylation due to a polymorphism in their MTHFR gene).

The multivitamin I recommend most often is the Phytomulti but I also like the Pure O.N.E. multi. Both are produced by companies that I trust to vet their ingredients and use a third party company to screen their products for purity. I wouldn't get them off of Amazon (even though I linked to them to show what they look like) because they may come from unreliable sources and even by re-packaged with sub-standard products. You want a vitamin product that your body can actually absorb and not one that you will just pee or poop out.

I buy these products and have patients buy them directly from me but I also use a reliable supplement site called Fullscript which you need to be invited to by your provider. Many of the supplements are available at therapeutic doses so they aren't open to the general public. If you want to purchase and don't have a Functional doctor, send me an email to KarenFMillerMD@gmail.com

Thirdly, I recommend a good broad spectrum probiotic. We have many different brands for patients but in general the best are made by Master Supplements and Klaire labs. I like to see 4 or more lactobacillus strains and 4 or more bifidobacterium strains. Maybe even Sacchromyces boulardii, a beneficial yeast. Colony counts should total at least 20 billion CFU (colony forming untis) to be of any benefit. The main thing a good probiotic does is improve your gut health. If you have poor gut function you should add probiotics with the help of a Functional Medicine doctor. Gut health impacts our mental health, immune health and ability to detox which impacts the risk of developing cancer.

Fourth, I think most people in North America don't get enough sun exposure because almost everyone I test has a vitamin D3 deficiency. A good quality vitamin D3 should have at least 5000IU. Most of my patients maintain their vitamin D3 levels with 5000IU daily but sometimes patients require more because vitamin D3 is critical for immune system function and if your situation causes your immune system to be overactive then you may need a higher maintenance dose. Have your doctor check your vitamin D3 levels at least once a year. (Right before flu season is a great time to make sure it is adequate)

Last but not least, most people will benefit from a high quality curcumin product. You get curcumin from the turmeric root so you can add turmeric root to smoothies and make tea from it but for a good anti-inflammatory and antioxidant action there are products that have intensified the effects by formulating the active ingredient to be delivered in a bioavailable way. I like Thorne's Meriva product that contains a phytosome complex of curcumin released in a time-released way or Integrative Therapeutics' Theracurmin HP with enhanced bioavailability and a high percentage of curcuminoids.

I take curcumin daily as it, like Fish Oil, is a powerful anti-inflammatory and antioxidant. It has been shown to help prevent heart disease, metabolic syndrome and Alzheimer's to name a few. It also increases Brain Derived Neurotropic Factor which does just what it sounds like, it helps increase growth of neurons so it improves brain and nervous system health. Curcumin can also help prevent growth of tumor cells and has been shown to help induce the death of cancer cells, a good reason to take it daily in our increasingly toxic environment.

So this is a very superficial review of my Top Five supplements. Almost everyone can benefit from these and if you have specific chronic conditions, you may need more than just these to get to your best health. If you want to locate a Functional medicine doctor to help you figure out which supplements would be best for you, you can use the 'Find a Practitioner' link on the IFM website or come see me! (I can do some phone consultations - email me at KarenFMillerMD@gmail.com for details.)







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