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Supplements are always a hot topic when it comes to healthy living, and rightfully so.
Supplements like vitamins and minerals are essential – absolutely necessary – to our bodies.
Here’s the gag: Our bodies can’t always make all the vitamins and minerals we need on their own. We have to get many of the essential vitamins and minerals from the foods we eat.
For most of us Americans, our diets flat out suck aren’t the best, which means we don’t always get all the nutrients we need from food.
That’s why it can be helpful, important, and sometimes even necessary to get those nutrients from other sources, which brings us to…dietary supplements!
But PLEASE don’t stop reading here because it’s not as cut-and-dry as it may seem.
Just because some dietary supplements are helpful doesn’t mean all of them are. It doesn’t even mean that all of them are safe!
In this post, you’ll find out
- what exactly supplements are (there are SO many that you may not even know),
- what kinds of vitamins and minerals your body needs, and
- how to make sure you’re using supplements safely.
(Check out part 2 of this post where I focus in on herbal supplements specifically.)
Why are dietary supplements so controversial?
Patients are always asking their pharmacists questions about supplements.
To be honest, we sometimes struggle to answer those questions the right way. This post is my attempt to fix that!
But why are supplements so tricky in the first place?
Well for one, we don’t know enough about them.
Supplements don’t have nearly as much research to support them as over-the-counter (OTC) and prescription medications do.
That’s because they don’t have to.
Makers of OTC and prescription drugs have to prove to the Food and Drug Administration (FDA) that their products are safe and that they work.
These laws DO NOT apply to supplement-makers.
Because of this, health care providers are extremely cautious when talking about supplements, which is understandable.
They aren’t in the habit of recommending products that have no data to show that they are safe or that they work.
What are dietary supplements?
You may hear the words herbals and supplements used interchangeably, but they shouldn’t be.
Think about it this way:
All herbals are supplements, but not all supplements are herbals.
All vitamins are supplements, but not all supplements are vitamins.
Supplements make up a huge category of micronutrients, which includes a whole bunch of smaller categories. The picture below will show you exactly what I mean.
Like I mentioned before, we don’t always get all the nutrients we need on our own.
Vitamins (like Vitamin B12) and minerals (like potassium) help your body work like it’s supposed to.
Not having enough of certain vitamins and minerals can either cause health problems or be the result of a health problem.
In either case, supplements can help us fill those gaps.
What are the most important vitamins and minerals your body needs?
Vitamins and minerals are extremely important to your body for lots of reasons.
There are hundreds of vitamins and minerals, but the ones we absolutely must have enough are are called essential.
Without essential vitamins and minerals, we would die.
Here’s a chart of the essential vitamins and minerals and what they do.
Has your doctor told you that you’re low or deficient in any of these essential vitamins and minerals? What can you do to fix that problem?
Try foods first
If your body is low in certain vitamins or minerals, you may need to supplement.
But there’s something you may want to consider before resorting to dietary supplements:
Some people consider taking a supplement to be more “natural” than taking a pharmaceutical.
But isn’t food even more “natural” than a vitamin or herb packed into a pill casing? Yep!
There are a few reasons it’s best to get most of the micronutrients you need through foods first:
1. Most times, your body can better digest the micronutrients found in foods (versus those that have been processed
into a pill or tablet form).
2. Some dietary supplements may have a certain amount of vitamins or minerals in them, but that doesn’t mean your
body can process all or any of it.
Here’s an example of what I mean in #2:
Have you noticed how many types calcium supplements there are? Maybe not, because they all say “calcium,” but the calcium can be delivered in different forms that act differently in the body.
Calcium carbonate (Tums) and calcium citrate (Citracal) are just two examples.
Calcium carbonate can only be absorbed in a very acidic environment, like your stomach, but even then, it needs more acid. Older people don’t have as much acid in their stomachs, which means they can’t absorb calcium from calcium carbonate. And people with GERD or acid reflux who take proton pump inhibitors (PPIs) also don’t have as much acid in their stomachs because of how PPIs work. So if either old people or people taking PPIs take calcium carbonate, their bodies aren’t actually absorbing that calcium.
On the other hand, calcium citrate is better absorbed all around, even by people with low stomach acid.
3. Your diet will probably be more balanced and whole foods-based if you’re actively trying to get more vitamins and
minerals through foods.
Consider this a challenge to change up your meal and snack planning to get more essential vitamins and minerals in your diet.
Sometimes, foods just aren’t enough
While “foods first” is the ideal strategy, it’s not a perfect strategy.
Some vitamins aren’t found in foods at all, at least not in the forms we need them.
Or they are found in very, very small amounts. It might not be practical to eat the amount of food that would be necessary to get a good amount of the nutrient.
One of the reasons we don’t get enough micronutrients from our food is that our food is so processed that the micronutrients are hardly there anymore.
The vitamin D that our bodies need is only found in a few foods. It mostly comes from sunlight, which many of us don’t get enough of.
In those cases and many others, supplements can be helpful. The key is to find a SAFE supplement!
Not all supplements are created equal
Supplements are not regulated by FDA in the same way that pharmaceuticals are. (This does not mean that supplements aren’t drugs. They are.)
That the government doesn’t regulate supplements as strictly as pharmaceuticals may be music to some ears, but this amount of freedom is risky.
The FDA makes sure pharmaceuticals are safe before they can be marketed and sold. (By the way, safe doesn’t mean perfect. All drugs, including supplements, have potential side effects.)
All drugs, including supplements, have potential side effects!
Find out 5 easy ways to research a drug’s side effects on your own.
By “safe,” I mean that FDA weighs the potential risks vs potential benefits of the drug and makes their decision to approve the drug based on those pros and cons.
For supplements, that safety data is not there. The effectiveness data isn’t either.
Supplement-makers don’t have to prove that their supplement is safe before it goes on the shelves for you to buy. They can choose to follow their own standards, but these standards aren’t…standard…across the board.
For this reason, when my patients ask, I only recommend supplements that are verified by the US Phamacopoeia (USP).
USP is an organization that sets quality standards for medicines and supplements.
If a supplement is USP-verified, it means that it has passed USP’s quality standards.
This is a completely optional process. Because the USP is a highly-respected healthcare organization, USP verification gives us healthcare providers a little more confidence in recommending them.
How do you find USP-verified supplements?
Finding USP-verified supplements is easy. Just visit the USP website here. You can learn more about how USP tests supplements for quality.
On this page, you can also find specific USP-verified products, brands that are USP-verified, and stores where you can find these products.
Spoiler alert: only 3 brands are USP-verified:
Do you need to take dietary supplements?
Whether or not you need supplements is something you and your doctor should discuss. In general, you may want to focus on the essential vitamins and minerals first.
In general, most of us are nutrient deficient and do need some extra help.
Pregnant women will likely be encouraged to take a prenatal vitamin that contains Vitamins B6, B12, and folate, which are necessary for health baby development.
Many women – pregnant or not – are low in iron, which is necessary for making sure there’s enough oxygen in your blood.
People who follow meatless diets may need to supplement with Vitamins B12 and Vitamin A.
People who take certain pharmaceuticals may need mineral supplements.
Aging adults may need certain supplements like Vitamin D and calcium as they get older.
For an individualized breakdown of what supplements may be good for you, consider seeing a doctor to get your bloodwork done and discussing the results with your doctor or a dietician.
Supplements themselves aren’t “bad.”
In fact, many of us need vitamin and mineral supplements. But the way we talk about them and think about them is very important.
Herbal supplements are a classic example of how misspeaking about supplements can be dangerous.
In fact, I wrote a completely separate post just to tackle all of those problems!
Leave a comment below sharing your thoughts about supplements. Do you take any supplements regularly?