Another Clinical Pearl Regarding Nutritional
   Supplements    (June 18, 2019)

If you recall, last time we met I was saying that a lot of very pricey supplements are a waste of money because before taking the giant step of absorbing anything at all, your body breaks everything you swallow down into the teeniest, tiniest, most basic molecular building blocks that it possibly can. Meaning that by the time it finally gets into your bloodstream, deer velvet is probably indistinguishable from a Krystal. Harsh but true, and we are courageous enough here to face a few harsh truths.

But I wasn’t done there. Nope!  Just in case that bit of reality wasn’t cruel enough, here is another one. It is also very likely that taking any nutrient supplement at all is a complete waste of money UNLESS YOU ARE ACTUALLY DEFICIENT IN IT. And most people these days are not deficient in most of the nutrient(s) that they are supplementing, and so they are wasting a ton of money.

A couple of years ago I wrote a newsletter that is still pretty much worth reading, if you are into that kind of thing. (Reading, I mean.) It was about multivitamins and it concluded that despite some lingering scientific controversy, because most Americans are deficient in one or more nutrients and because there was solid evidence showing some better health among people who take a multivitamin, doing so is probably a good idea. Should you have a lot of time on your hands this morning, here’s the link to it:

http://www.drdianeholmes.com/multivitamins-are-fabulous-maybe.html

Because the majority of Americans ARE deficient in one or more nutrients, albeit marginally, it makes sense that taking a decent multivitamin would produce some measurable (if slight) improvements in health. Plus multis are cheap and provide a very wide spectrum of nutrients in small doses, so they won’t hurt you even if they are unnecessary. Plus you'd only be out about $20 a year if you do take them. But aside from multis, if you are NOT deficient, is there a point to taking supplements? The answer is “usually not” and very close to a solid “no”.

For example. Most people know that vitamin A is really important for healthy eyes. But if you have night blindness, taking vitamin A won’t do jack for it UNLESS YOU ARE ACTUALLY DEFICIENT IN VITAMIN A AND THAT IS WHAT IS CAUSING THE NIGHT BLINDNESS. Lack of B12 can cause numbness in the hands and feet, but if you have that problem and your B12 levels are normal, taking B12 isn’t going to help one itty bitty bit. Etc., etc., etc. This is true of all the nutrients that we know much about.

This is not the final word, of course. It is not impossible that there are some nutrients that, taken in large doses, will help you with some conditions even if you are not technically deficient in those nutrients. But right now I can’t think of a single one. And that is probably the most likely reason why so much research into “does vitamin X help disease blah blah” turns up empty. Because the modern diet is really pretty decent.

(I KNOW that our diet sucks. We eat too much, we eat too much junk, the produce isn’t what it used to be and loses nutrition during transport, etc., etc., etc. But for most of human history we have had diets that were far worse. Just getting enough calories of any kind at all was a battle most of the time. If you managed that, you were probably eating only a couple of foods, maybe just because it was the only thing that would last the winter and it was better than boiling up the wallpaper for paste soup. Compared to most peoples for most of history, our diet is really good and our deficiencies are marginal.)

So is taking any supplement besides a multivitamin pointless? Maybe. (“Maybe!” Spoken like a true scientist! I am SO proud of me! Wait, I can do even better than that. “We need to do more research.” There! Perfect!)

Ok, I am sorry. I am being unnecessarily mean to scientists here. The reason scientists say “maybe” and “we need to do more research” all the time is because every time they manage to answer a question, a bunch more questions immediately pop up and people want answers to them right NOW and all that the poor scientists can say is “we don’t know that yet. We can only answer one question at a time. Just wait, ok?”. And then people get annoyed, make fun of them and won’t give them any more grant money. That’s why I’m not a scientist.

Taking a supplement IS probably useless unless you are deficient in that particular nutrient. But we are far, far from knowing everything there is to know about deficiencies, and about genetic variants among people that may give them different requirements. (More questions. See?) So although you might be spending a lot of money unnecessarily on useless supplements, that doesn’t mean that ALL supplements are useless. Or that you have to waste your money if you buy them.

As long as we figure out how to use them properly, supplements may be very, VERY helpful. The problem may very well be not that supplements aren’t helpful, but that we don’t choose them properly. I will talk more about that next time.

--dr. diane holmes
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