One of the most common questions I am asked is-are supplements useful?  Reflecting on last weeks’ column, provides us with one of the reasons why I and my Integrative Medicine colleagues feel they are often helpful.  The wild foods we were evolutionarily designed to eat, contained more ‘good’ fats, vitamins, and minerals.  The pre-industrial revolution fruits and vegetables contained 40% more vitamins and minerals than those same foods today.

Over-consuming the empty calories in nutritionally deficient processed foods (including so called ‘healthy’ bars) effectively means we are ‘starving’ despite eating these ‘food-like substances.  This biochemical state of under-nourishment (even in those people with obesity) contributes to many patients drive to eat too much food.

There are so many other reasons why we need supplements regardless of how well we eat.   These include:

  • the chemical soup we breathe in/put on our skin/ingest adds to increased nutrient demand especially from our detoxification pathways.
  • added stressors associated with modern living, as stress hormones also need to be ‘detoxified’.
  • depletion of nutrients from our soils.
  • picking food before it is ripe (and therefore before it achieves optimal nutrient content).
  • poor food storage, handling, and transport.
  • genetic modification of traditional foods such as wheat is reducing nutritional content and in the case of wheat is increasing gluten content.
  • many of us are deficient in stomach acid and digestive enzymes. This is particularly the case for stomach acid thanks to the over-use of stomach acid lowering medications such as ‘quickeze’ and ‘losec’.  Most people on these medications actually need the opposite, i.e. supplemental stomach acid.  If levels of stomach acid and digestive enzymes are low we are not able to absorb nutrients from our food as well as those with optimal levels.
  • if medications have to be prescribed, some, e.g. ‘Prozac’ will not work as well. This is because they require us to ingest the building blocks of neurotransmitters to do their job.

Whilst supplements are often needed, it is however critical that they are properly prescribed with someone trained in their use.  This often requires testing of deficiencies, most of which are unfortunately not funded under public healthcare unless strict criteria are met, e.g. vitamin D.

Another critical consideration is the quality of the supplement.  I will go more into this next week, however as a general rule pharmaceutical grade is always best.  This is because they contain what the label states they contain (and no surprises) and also they contain the right form of ingredients.  An example of this is zinc, with a more easily absorbed form being zinc picolinate compared to the cheaper zinc citrate form.

Also in a future piece, I will summarise the risks and benefits of my most commonly prescribed supplements.

Yes, food is first and yes, supplements can be a minefield, but the right form prescribed by the right person can make a striking difference to the most complex of patients.  This phenomenon I have seen time and time again in my practice and I would love you to see that in your patients.  The Australasian College of Nutritional and Environmental Medicine (www.acnem.org.au) offers superb training in the detection and management of nutritional deficiencies.

Dr Tracy Chandler BSc (Hons) MBChB FRNZCGP FNZSCM, PGDipSEM, Cert Dermoscopy, Cert Homeopathy, MACNEM member, gained her degree in England and worked as a GP in Timaru before doing postgraduate training in sports, skin and integrative medicine.

She specialised in integrative (wellness) medicine in line with her increasing interest in the impact of nutrition and environment on health and wellbeing.

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