Supplements

 
     Do we need to take supplements?  Do we need vitamins and other plant based supplements in order to be healthy?   I get these questions every day in my practice.  I could answer with a yes or no, but the answer is much more complex than a simple answer.  First, if a person ate an ideal diet consisting of mostly vegetables and low sugar fruits, lean meats like fish, healthy fats like nuts, avocados, and coconut,  drank plenty of water, avoided extra sugar, got adequate sleep, significant exercise, and avoided stress, that person would not require extra supplements.
 
     If you are that person, I'd like to meet you.  I doubt they exist.  So, that means I need supplements in my diet.  Right?   Not so fast.  Our health is determined by what I call the 5 Core Factors.  Additional benefits to our health are found in what I call Satellite Factors.  Satellite Factors include supplements. Let's take a look at the Five Core Factors of Health.
1.  Nutrition
2.  Physical Activity ie. Exercise
3.  Metabolic Balance
4.  Hormone Balance
5.  Psychological Stability
 
     If these Five Core Factors are not dealt with and optimized, then no supplement is going to provide much benefit.  Example:  A diabetic patient wants to know if Berberine will help take care of his diabetes which is not in good control.   I tell them that if they are not eating a healthy, reduced calorie, reduced carbohydrate diet, getting daily moderate physical activity, balancing metabolic and hormonal issues, and don't have good control of their emotions and thinking about this disorder, Berberine will be of no help to them in the long run.
 
     Berberine in this case can be a great supplement with excellent benefit if the person focuses on the Five Core Factors first.  Taking supplements to correct our poor health habits will not be beneficial.  After working hard on the Core Factors and incorporating that into a daily plan, specific supplements can make a huge difference when properly targeted.  By targeted, I mean used for a specific purpose and not just taken because someone said so.
 
     I do advise that everyone take a couple of daily supplements no matter what their health condition is.  First is Vitamin D.  I advise 2000 units of Vitamin D3 to be taken every day.  If testing reveals low levels, up to 5000 units daily may be required.  Another supplement that everyone should take is Omega 3 Fatty Acids from wild fish.  Most people don't eat much fish and fried fish sticks don't count.  This fish oil supplement will benefit cardiovascular health, joint health, lipid function, and brain health.  Of course it works best when the Core Health Factors are achieved first.
 
     Let's assume you are working on the Five Core Health Factors and improving your overall health on purpose.  What supplementation would be good for you?   I'll go over several specific supplements that may target specific health issues.  Taking these supplements are beneficial satellites to the Core Five.
 
     I'd like to review some important and maybe less familiar supplements.
 
     First be sure to get  Vitamin D3 and take Omega 3 Fatty Acids from wild fish as mentioned.
 
     Choline, a part of Phosphotidylcholine, is critical for formation of cell membranes and helps to keep fat from depositing in our liver.  Another term for Phosphotidylcholine is Lecithin.  Great sources of Choline are from eating liver, nuts, cruciferous veggies, egg yolks, and meat.  It can also be taken as a supplement called Lecithin.  Experts recommend about 500mg per day and if a person is obese or has fatty liver, about 1000mg daily is recommended.
 
     NAD+ and Nicotinamide Riboside are vital for the production of cellular energy.  As we age these substances decrease for various reasons.  Without getting into the biochemistry of these factors, it should be noted that these substances are diminished by high glucose, high calories, and inflammatory states such as insulin resistance.  They are increased by fasting, restricted calories, and vigorous exercise.  These substances regulate the production of energy in the cells of our body.  Proper energy usage and production in our cells can enhance cellular, organ, and body function and performance possibly leading to a longer healthier life.  It is somewhat difficult to find the Nicotinamide Riboside and commonly sold Nicotinamide does not substitute for this.
 
     Berberine as mentioned above in my example acts like a prescription drug known as Metformin.  Berberine works to make our energy producing machinery inside each cell more efficient.  It produces some stress on the cell which makes it function better and has been shown in studies to be linked to increased longevity and diminished cancer risk.
 
     Vitamin B12 and B6 known as cyanocobalamin and folic acid respectively are critically important in keeping homocysteine levels lower.  Elevated Homocysteine levels are associated with elevated cardiac risk. When I recommend B12 and B6 I use a combination supplement and use the methylated form.  One would take a single capsule of Methyl B12 and Methylated B6 daily, typically with 1000mcg of each vitamin in it.
 
     K2 is a little talked about vitamin.  Most people are familiar with it due to its effect on the blood thinner Coumadin (Warfarin).  It is found in dark green leafy vegetables.  It promotes clotting.  Another important function is its effect on our  Calcium.  In this role it is a Calcium Director.  We absorb calcium in the foods we eat.  This calcium should only go to two places in our body, bone and teeth.  Calcium can become misdirected and end up in places where it doesn't belong such as the walls of our blood vessels causing blood vessel stiffness and increased risk of cardiovascular disease.   Vitamin K2 turns on an enzyme that pumps calcium out of the artery wall.  Foods richest in Vitamin K2 are grass fed meats and butter, egg yolks, fermented soy, and chicken breast.  It is also more easily available in a supplement and the correct dose is 100 -200 mcg daily with a meal.
 
     Probiotics are the rage now.  Our body, especially our digestive tract contains trillions of bacteria.   There are good bacteria and bad bacteria.  The good bacteria help our immune system, protect our heart, are anti-inflammatory, and even have anti-depressant effects.  It is also extremely important in the health of our gut.  A diet high in sugar and processed foods promote growth of the wrong type of bacteria in our gut.  Eating fruits, veggies, and fermented products like yogurt and sauerkraut enhance growth of the good bacteria.  Most store bought yogurts don't have adequate amounts of bacteria in them.  Probiotics are also effective in reducing diarrhea associated with taking antibiotics, if they contain the right bacteria and are taken at the right time, usually 2 hours before antibiotic dosing.  Saccharomyces boulardii is the best bacteria for this.
 
     Coenzyme Q 10 is important in our body and helps produce energy in our cells and is an antioxidant.  As we age our CoQ10 levels decrease and when taking a statin CoQ10 is also depleted.  Studies show that people low in CoQ10 have greater heart damage with a heart attack than those with adequate levels of this substance.  I have all of my patients and those over 65 take 100 to 300mg of CoQ10 daily.
 
     A final thought on taking supplements.  Supplements as I mentioned are not drugs.  They should not be studied like drugs, but as necessary components of a healthy functioning body.  Supplements do not treat illness, but support the function of our cells, tissues, and organs.  They are to be selected wisely in conjunction with improving the Five Core Health Factors.  They are not substitutes for a bad lifestyle.
 
     Time to improve the 5 Core Factors and determine, with the help of a knowledgeable health care Doctor or provider, if certain supplements are needed to optimize your health.

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