5 Questions to Consider Before You Supplement
Naturopathic docs (NDs) are often known as supplement pushers – and for good reason. We use them a LOT. There’s a supplement for nearly every physiologic need and process, and when used correctly, they’re a great way to bolster overall health.
There’s a darker side to supplement use though, wherein companies and providers take advantage of customer and patient wallets with unwarranted promises of shining health and wellness. Supplements are big business, to the tune of billions of dollars annually…
So how can you be a conscious consumer and ensure you’re spending your dollars on useful products, rather than expensive urine?
To start, let’s do some education. Here are 5 questions I ask myself and talk through with my patients as we evaluate treatment options, including supplement use.
What are your health goals?
Before we even get to the issue of whether to supplement or not to supplement, where are you trying to get to in terms of your health? In your life, even?
If you’re in a spot where you’ve got $100 to allocate to extra health expenses per month, a supplement regimen that costs $500 per month is absolutely not for you, even if it tap dances for entertainment at dinnertime.
If, however, you’re trying to optimize your fitness levels as you train for a marathon or an olympic lifting competition and have a budget of $3,000 for trainers, treatments, doctors, etc, a $500 supplement regimen may be perfect.
Most folks I work with are looking to:
- Have energy and focus for their day to day
- Even out their mood
- Stay well for as long as possible, or
- Look after themselves after having focused on everyone else for 5, 10, 20 years, and
- Have a modest budget to work with (somewhere between $50-200/month for supplements).
A provider worth their salt will be able to marry medically necessary care with your goals and treatment preferences most (though maybe not all) of the time.
Is it *actually* necessary?
When folks come in to see me for the first time, I ask them to bring ALL the things they take regularly. It’s not abnormal for someone to come in with a full-sized grocery bag full to the top with various products.
Over the course of our conversation, as I note the dosages they use, I ask “why are you taking this?” Much of the time, the response is “I’m not sure, actually.”
Part of this is an education issue – we’re told by so and so that x product helped them, so we start taking it. Or we see on the news that Miracle Product Y is a panacea, so we start taking that. Sometimes a provider we saw a few years ago recommended something, and we just never thought to reconsider if we still needed it. No shame, it happens to the best of us!
Remember: supplements are meant to be just that. Supplemental. Humans are designed to get nutrients from our food, and supplements are a way to plug a gap here or there. Wellness culture purports supplements as absolutely essential in every case, and the fact is, they’re just not.
Vitamin D is a great example, particularly as its immune system benefits have been lauded over the last few years. The thing is, supplemental vitamin D is always inferior to getting some sun. And not everyone is deficient in Vitamin D. On top of that, more isn’t more when it comes to nutrients.
Before you begin taking anything, consider: will this treatment help me reach my goals? If not, is it medically recommended, because the risk to my health of not using it is significant?
Talk with your provider, do your own research, and if the answers are no, this won’t help me reach my goals, and the risk of not using it is simply saving some money… well, on to the next option!
In my experience, Most supplements aren’t necessary for most people. They’re shiny and sexy and have promises of being exceptional attached. Exciting, but not necessary. It’s worth evaluating whether or not the products you’re using (or have been recommended to use) are truly needed to help you achieve your health goals.
Does it carry risk?
Many folks come to natural medicine because it’s, well, natural! And if it’s natural, it must be safe, right?
I’ve had folks have terrible allergic reactions to herbal formulations, and I’ve heard tell of folks who’ve had tremendous adverse reactions to homeopathic medicines. Periodically, if someone’s immune and elimination systems are overloaded, they’ll develop miserable reactions to the most gentle natural products.
No medical treatment, whether natural or conventional, is 100% risk free.
Whatever your provider recommends, they should be able to walk you through potential risks of products. Risks that may include (just to name a few): allergic reactions, changes in mood, altered sleep patterns, stomach and GI upset, effects on fertility…
By way of example, senna tea is often prescribed for constipation. If used just a few times to get things moving, no problem. Used continuously for weeks on end, it can cause dependence.
Additionally, natural product formulations vary from manufacturer to manufacturer. Periodically I’ll prescribe phosphatidylserine to support sleep quality. And, at the same dose, some products cause folks to have nightmares, while others don’t. And it’s never the same company that causes the side effect, if it comes up…
Another consideration is whether or not there’s a risk of interaction between pharmaceutical medication (i.e. prescription drugs) and natural products. Grapefruit is natural, delicious to some, and nutritious… yet it is contraindicated with the use of certain medications. Grapefruit slows down the liver’s breakdown of those drugs, thereby increasing the amount of drug circulating in the body. Potentially dangerous.
St Johns Wort is another natural product that is contraindicated with certain medications for similar reasons.
Someone taking a selective serotonin reuptake inhibitor (SSRI) is advised against using 5HTP or l-tyrosine. This is due to the risk of inducing serotonin syndrome, a potentially fatal condition caused by excessive amounts of serotonin in the body.
So, be careful of making the mistake that ‘natural’ = safe or risk free. In many cases, it doesn’t.
What’s the timeline?
Before you commit to any product, ask about timelines:
- How long should you expect before you start to see results? Senna tea takes a couple of hours, while Deproloft (a supplement used for low mood and anxiety) can take a few weeks.
- How frequently will you need to take this product? Vitamin D can be dosed weekly or daily, depending on the form and dose in addition to being dosed seasonally.
- Will you need to take this product indefinitely, for a few months, a year? St Johns Wort may be used in the late summer, fall and winter months for seasonal depression for years. A strong homeopathic remedy may only need to be dosed once. Magnesium bisglycinate may be something needed daily indefinitely for help with muscle tension caused by anxiety.
Having a sense of what to expect regarding timelines simply helps to make an informed decision. If you struggle to take things every day, maybe you want to ask if there’s a weekly option? Or, do you really need to take it every day, or is 3-5 times per week sufficient?
Can I be sure of the quality?
The supplement industry is largely unregulated by the FDA. Many manufacturers operate on an honor system, and labels may or may not accurately reflect the product in the bottle. 
Piper methisticum (aka Kava) is ‘known’ to cause liver damage… except that it’s also a plant used in traditional medicine, and isn’t known to cause liver damage… so what gives? It’s unclear at this time if liver damage from kava is actually due to the kava, extraction methods, mold contamination, or adulteration (use of an altogether different substance, and calling it kava).[2,3]
This is the most important reason to work with a qualified healthcare professional who understands and knows the supplement industry. Oftentimes, high quality supplement companies only sell to licensed healthcare providers. These companies maintain high standards, and are able to produce third party testing results that validate that their products actually are what they say they are, and are free of potentially harmful contaminants.
Even if you see a high-quality brand marketed on popular sales sites, you may not be able to verify that that product is from that company. It’s incredibly easy to duplicate packaging and fill a bottle with an inert or cheap substance and pass it off as a credible supplement.
By working with a qualified provider (naturopathic physician, functional medicine MD), your odds of receiving effective supplements that will help you reach your health goals on your budget is vastly improved.
Schedule a visit with Dr Katherine Hofmann to see if your supplements are working for you and to learn what options are available to help you achieve your health goals!