Do You Need Something Extra? Working Your Way Through The Maze of Supplements

There’s a lot of noise out there these days about what constitutes healthy eating, what nutritional guidelines you should follow, and when, if ever, nutritional supplements should be considered to support your healthy aging. While we have regularly addressed the benefits and risks of nutritional supplements, it’s important to review and reconsider the prevailing advice, especially as your own health circumstances evolve. As we’ve previously noted, the vitamin and supplement industry is a big business in this country (estimates are that it constitutes a $192 billion industry) and it’s only loosely regulated, as the FDA considers vitamins and supplements foods rather than medications. Given that estimates are that the average American spends about $50 a month on supplements (for everything from brain health to bone health to sleep and longevity), it’s important to understand what the data is concerning the value of supplements and when their use can pose real risks. If you’re interested in a better general understanding of the safe use of supplements, consider clicking here to sign up for an upcoming free webinar sponsored by the MedShadow Foundation.

Generally speaking, there are a host of nutrients that experts recommend you stay on top of as you get older. For many, if not most of these, you should be able to meet recommended requirements through your diet, which is often the preferred way to make sure you stay nutritionally healthy. A recent Washington Post article spelled out the essentials, which include calcium, Vitamin D, Vitamin B6, Vitamin B12, protein, and fiber. Other experts include in that list such nutrients as Omega-3s, Magnesium, and Zinc. Before you consider supplementation, it’s important to understand your own levels of these nutrients, for which your doctor can conduct a blood test, and to discuss with your health care provider whether you can achieve recommended levels through improvements in your diet or whether supplementation would be advised. For example, many experts suggest you can meet your magnesium requirements through diet changes, and that B12 levels can also be met through diet or a general multivitamin. It’s recommended that B12 supplements should only be considered after testing has confirmed your levels are insufficient. 

Whether or not other supplements are worth the money or truly provide the promised benefits can require a complicated analysis of your own personal health circumstances and what you are proposing to take. For example, when it comes to supplements that purport to support or improve your brain functioning, for the most part, the scientific data is just not present yet. While it appears possible that some ingredients in some supplements may eventually prove important, right now there are no definitive studies that demonstrate that any supplements are useful for preventing or treating cognitive impairment (of course, we do know that many lifestyle behaviors, including exercise, healthy eating, sleep, and social engagement, can be immensely useful in this area). This is perhaps worrisome given that a national survey revealed that 25% of adults over age 50 take at least one supplement to improve their brain health, despite the lack of proof of benefit. Similarly, when it comes to supplements that supposedly support healthy aging and longevity, we continue to lack adequate scientific evidence of supplements that are both safe and effective in humans for the purpose of longevity, and there are many overhyped supplements whose marketing is stronger than their scientific evidence of value.

Still, some may say that even if strong scientific evidence is lacking, there is still some possible benefit, and no downside to taking some supplements. The problem with that thinking is that everyone is different in terms of their genetic makeup, the medications they take, and the possible reactions they will have to a particular supplement. No medication- or supplement- is completely risk-free, and some evidence has been mounting about possible risks, even of supplements that may otherwise be lauded as valuable. So, for example, take Omega-3s. In healthy individuals, most aging experts recommend- either through diet or possibly through supplementation- that older adults achieve a certain level, depending on age. However, new research has just been published that reports that using Omega-3s for cognitive health may now be in question. An observational study found that in older adults, Omega-3 supplementation could actually lead to accelerated cognitive decline. So a word of caution to those who take Omega-3s to support their brain health.

A more concerning recent study involved cancer patients taking supplements to ease chemotherapy symptoms. In this study, published in Cancer Letters, pancreatic cancer patients ingesting Vitamin B3 derivatives were found to have blocked the benefits of their chemotherapy due to the supplements, thus helping cancer cells survive and resist treatment.  While such supplements may be perfectly fine for healthy individuals, the study demonstrates that your individual health profile may mean that a perfectly harmless (and possibly beneficial) supplement could cause deadly serious consequences in certain patient populations.

Moral of this story? There’s much we don’t know about supplements: often, we don’t know the integrity of their ingredients, the health value of their promises, or the risks they may actually pose to specific individuals. So the clear advice is to consult with your health care provider when considering a supplement and proceed with caution, as you may be taking a chance on your health rather than receiving the benefits you were promised.