It is frequently assumed that I take many supplements as part of my health routine and this association with my profession sometimes frustrates me yet I know there is truth in it; a lot of practitioners I know do have extensive supplement regimens and recommend similar when working with patients. It’s really no different from associating your standard MD with pharmaceuticals. Just as with prescription medications, though, supplements are a tool and I feel this tool is often abused (as are pharmaceuticals). And I absolutely understand it – these things are a simple way to address many issues – but oftentimes I see people equating supplement intake to ideal health and this is a thought I mostly disagree with, especially when there are health behaviors that could provide similar benefit. I see overuse of supplements all the time with patients and I blame a lot of it on the wellness industry – many colleagues and other functional providers included. The industry likes to take a health issue and sensationalize messages around it making a lot of people feel they need to be taking something in order to be truly healthy or to solve a particular issue. But this isn’t always the case. And it sounds no different from pharmaceutical messaging to me.
The supplement industry is the quieter sibling of the of the pharmaceutical industry, in my opinion, but just as rapacious. As an example, Nestle owns a surprising portion of the cheaper supplement brands out there, is actively acquiring privately held, higher-end supplement companies, and announced this year they are developing personalized nutrition assessments, the results of which will undoubtedly steer you to buy more of their products. The wellness industry is set to be worth 50 billion by 2025 and the majority of it could care less about your actual health. And this isn’t wrong, this is business; Nestle has identified a growing market and is aggressively tapping into it. But you should put your critical thinking hat on as you continue to be bombarded by the messaging the industry spews at you – to understand that it’s largely advertising designed to make you think you need something you probably don’t, even if the product being offered is legitimate.
While the majority of the companies in the wellness industry are in it for the money, most of the health-oriented practitioners within it are not and these individuals can help you navigate the field for your benefit. The number of supplements and tests available to you is growing exponentially and, while many may well be useful, naturopathic doctors and similarly-trained practitioners are the only true experts in whether you need them and can help guide you in knowing what’s worth your time and money. I come across many patients that have tried to sort through this information themselves or relied on friends and the internet for advice and often find that :
- They are taking something that is not indicated
- They have no benchmark to know if something is helping them or not
- They are not taking a therapeutic dosage (worse yet, dosing too much)
- They are using a less effective chemical form or delivery method
- The supplement is poor quality with excessive fillers and potential allergens and contaminants
- There are better alternatives, sometimes cheaper as well
I do think supplements are largely beneficial and I will use them on myself as the need arises and most certainly with patients who I feel could use the support. The main instances in which I do this are to:
- Support the body with an irreversible condition: chronic illness takes a systemic toll on the body and I use long-term supplementation in these patients for palliation of symptoms, to support weakened or dysfunctional systems that are part of the illness or consequences of it, or to replace nutrients that are more quickly depleted in the chronic disease state and by the pharmaceuticals often involved to treat it.
- Support of a long-term issue: in most cases, the longer an issue has existed the longer the road to recovery will be. I use supplements short-term in these cases as treatment and/or to provide support to the body and help with symptoms while we work on the longer-term foundational pieces that will help set them up to no longer depend on these supplements in the future.
- Correct malnourishment or overt/borderline deficient states: this may occur due to a chronic illness, older age, lack of dietary intake, increased need (e.g. pregnancy), increased elimination states (diarrhea, heavy perspiration, blood loss, etc.) or, at times, genetic SNPs that make it more difficult for some to maintain certain nutrient levels. Many medications also deplete our nutrient status by either directly disrupting absorption or indirectly by increasing the demand for these nutrients in the metabolism of the drug.
- Acute needs: illness, pain
- Prophylactically: to help stave off illness or known health issue ahead of a potential trigger such as being around someone who is ill or risk of a urinary tract infection. Or a pending hangover 😉
- Pharmaceutical replacement: the side effects from medication can make it hard for some to continue treatment and sometimes there is an effective herbal alternative to consider. Supplements may also be used to aid in the weaning off of a pharmaceutical.
I don’t use supplements for the “extra” nutrients or support in the absence of an issue/complaint or to “keep” me healthy or to “biohack” (this trend drives me nuts) – the best health is often achieved just by having a good handle on the foundational pieces. My main message here is that supplements are similar to pharmaceuticals in a lot of ways and we should be cognizant of dependence on them for our health. A state of health, to me, is one in which we don’t rely so heavily on these things – easier said than done, at times, but something I help all my patients work toward if ideal health is the goal.