Can you get all of the nutrition you need through food? This is a common question in my office. It seems simple. If you eat a wide variety of foods with plenty of fruits and vegetables, shouldn't that be enough? Doesn't a "healthy" diet provide a plethora of vitamins, minerals, antioxidants, and other nutrients?
I wish it was that easy. It would make my job much simpler! Unfortunately, many obstacles get in the way of maintaining a perfect nutritional status.
5 Reasons why you may need Vitamin or Mineral Supplementation:
#1 Prescription or "over the counter" medications
According to recent statistics released by the Centers of Disease Control and Prevention, 49% of Americans take prescription drugs. Many prescriptions can decrease certain nutrients in our bodies, causing much higher needs. Some of the most common medications with problems include:
- Heartburn and Antacid medications including both "over the counter" and prescription varieties like Pepcid, Zantac, Prilosec, or Prevacid. Heartburn is also known as Gastroesophageal Reflux or GERD. These medications most commonly interfere with Vitamin B12 absorption, but can also affect Folic Acid, Calcium, Vitamin D, Iron, and Zinc. When I see a patient with fatigue and problems with concentration who has been on a one of these medications for more than 6 months, I always recommend supplementation with B12 or checking a blood level.
- Oral Birth Control pills used over a long period of time can cause low or deficient levels of many B vitamins as well as Folic Acid, Zinc, Selenium, and Magnesium. I have many female patients who come to me with complaints of chronic headaches, muscle cramps, or chronic dry eyes and skin. These symptoms can be connected to low levels of B12, Riboflavin, and Magnesium.
- Cholesterol Lowering and Blood Pressure medications are extremely common in our country. As the obesity rate rises, so does the incidence of heart disease. CoQ10 (Ubiquinol) is found in every cell in the body, but decreases with age. It is required to provide energy to cells and works as a major antioxidant. Unfortunately, certain heart medications (Statin drugs like Lipitor, Zocor, and Crestor) used for lowering cholesterol and certain blood pressure lowering drugs can decrease amounts of naturally occurring CoQ10 in the body. This can sometimes result in extreme fatigue and muscle cramps. The Physicians Digital Reference (PDR) recommends doctors consider CoQ10 for patients taking Statin drugs, especially for those experiencing these symptoms.
#2 Dietary Restrictions can limit your food selections.
Sometimes what is an ideal diet for one health condition can rob you of nutrients you need. I highly recommend a mostly plant based diet for many people with chronic conditions such as Diabetes and Heart Disease, but this can be at the expense of Iron or Vitamin B12. The richest sources come from animal products. Combine this diet with somebody who routinely takes Antacids or Heartburn medication and this increases their risk of low levels even more! Dairy allergies or sensitivities are common. Vital nutrients such as Calcium, Vitamin D, and Riboflavin may be low if a conscious effort to add non-dairy sources does not happen. This could put you at risk for osteoporosis.
#3 Nutrient Depletion of food.
These days, food is transported from all over the world to our grocery stores and eventually to our table. The long transit times can decrease nutrient levels. Soil depletion also plays a role. A landmark study on this topic was published way back in 2004. It was entitled Changes in USDA food composition data for 43 garden crops, 1950 to 1999. This study reviews measurements of 43 garden crops for 13 nutrients and how the data changed between 1950 and 1999. The results show that for 6 nutrients—Protein, Calcium, Phosphorus, Iron, Riboflavin (Vitamin B2), and Ascorbic Acid (Vitamin C). The medium decline was between 6% (for protein) and 38% (for Riboflavin). The reality is the nutrients obtained from food alone can not always be guaranteed.
#4 Genetic Mutations
Science is moving at a high speed in this area. Your DNA is complex and research is recognizing that SNPs (Single Nucleotide Polymorphisms) significantly affect your health risks including your ability to change vitamins and minerals into their active forms. I like to describe this to patients as a hiccup in an otherwise flawless speech. One example getting a lot of attention in the past few years is the MTHFR (Methylenetetrahydrofolate Reductase) mutation. A defect can prevent your body from turning Folate into an active form that your body can use. This can lead to many problems including a higher risk of heart disease. Folate can be checked with a blood analysis. Increasing food sources of Folate in your diet (more leafy greens) can help, but additional supplementation is often needed.
#5 Lifestyle Habits (alcohol, smoking, and stress)
These can affect absorption and cause higher needs for certain nutrients. Heavy alcohol consumption can most commonly effect Vitamin B12, B6, Folate, and Thiamine. Moderate drinking is defined as up to 1 drink per day for women and up to 2 drinks per day for men. More than this on a regular basis could negatively effect your health. Smoking and stress can decrease you body's antioxidant status including important disease fighters such as Vitamin C, E, and Glutathione.
Are all Supplements Safe?
Supplements include everything from vitamins and minerals to herbs and digestive enzymes. They may be sold in the form of capsules, tablets, powders, gels, or liquids.Dietary supplements are regulated by the U.S. Food and Drug Administration (FDA), but they are only involved in regulation after you already see it on the shelves! Dietary Supplements are categorized as food and not drugs, so they are not required by law to go through the same kind of testing as drug products.There are several third party organizations that independently monitor and verify product quality. However, this is voluntary, so many companies are not verified. When buying any "other the counter" supplements, look for third party verification from USP (US Pharmacopoeia) or NSF International on the label. Consumer Labs also does a great job of testing and evaluating dietary supplements. You can look for these verifications, but this doesn't guarantee that this is the right product for you. There is much to be considered on an individual basis. Also, the highest quality products with minimal additives and preservatives tend to only be sold to healthcare professionals.
- Hoyumpa AM. Mechanisms of vitamin deficiencies in alcoholism. Alcohol Clin Exp Res 1986:10:573-581.