'Unlike a book or TV recommendation, supplements need to be taken a little more seriously.'
Authors: Josie Shillabeer & Chandy Rodgers
While you should be able to get all the nutrients you need from a well balanced ‘whole foods’ diet there are times when supplements might be needed. But just because a supplement is readily available from your local wholefood shop, supermarket, pharmacy, online, or is prescribed by your GP, this does not guarantee that it is safe, effective or that it provides value for money.
In this post we are going to share with you some of the essential things you should think about before buying or taking a supplement, including:
Do you really need it?
Who recommended it to you?
Who is most at risk?
How much should you it?
When should you take it?
How to stay safe when taking supplements.
Other things to think about.
Do I really need it?
Supplements can be a really useful way to support and optimise your health and wellbeing, however, in the majority of cases they should not be your first choice. All too often people use supplements without thinking about the potential root cause/s of their health concerns, such as their diet and lifestyle.
For example taking:
a multi vitamin alongside an unbalanced, low nutrient diet.
vitamin D rather than getting out in the sun.
a stool bulker rather than eating more fibre.
a hair, skin and nails combo rather than first focusing on eating more protein and beneficial fats.
sleep support supplements while continuing to watch thrillers and drinking lots of caffeine.
If you would like to know more about what supplements are and who should be taking them, check out our last blog post HERE. If you would like to begin to understand what the root cause/s of your health concerns are and how to improve your diet before you think about taking a supplement, check out our online course 'Nutrition: The Corner Pieces' HERE.
Alternatively, if you plan to or are currently taking supplements but you already have a balanced diet and a healthy lifestyle you may be wasting your money by taking nutrients and other compounds that your body does not need but in addition to this you may be putting yourself at risk.
Who recommended it?
Supplements can be recommended by your healthcare practitioner, a pharmacist, shop assistant, colleagues, friends, your favourite podcast host and in numerous adverts from magazines to social media. Unlike, a book or TV recommendation supplements need to be taken a little more seriously.
Supplements can have a very potent effect, by this I mean that they can act a bit like medications. They can have both a positive and negative effect on your health, they can cause side effects, you can have too little or too much and they can interact with your medications and other supplements.
While recommendations can be an incredibly useful way of finding out about a great product, it is important that you do your own research and take responsibility for your own health.
Always tell your GP or healthcare practitioner about any existing health conditions, or other supplements or medications you are taking. With new products emerging daily it is difficult for them to keep up to date with all the potential risk factors but you can ask your pharmacist to double check for interactions if you have any concerns.
In addition to this, never assume that all supplements are safe and effective. Just because someone is a great sales person, it does not mean that they are a qualified nutritional therapist who knows what to look out for in terms its effectiveness, quality, value for money and risks. You can find a list of qualified Nutritional Therapists HERE.
Who is most at risk?
There are certain people who should be extra cautious when taking supplements.
Pregnant or Breastfeeding
Ethically it is difficult to research the safety of supplements in pregnancy and whilst breastfeeding. Some might be helpful, but others could carry risks to mother or baby so it is always advisable to seek advice from your healthcare provider, and ideally one who specialises in this area. Click HERE for our Practitioner Directory.
Infants & Children
Some supplements could be harmful to infants and children. The main reason for this, is that their organs are not as developed as adults, such as, their liver and kidney making it harder for them to breakdown, use and remove it from their body. Plus, as in pregnancy and breastfeeding it is unethical to test on those under the age of consent and therefore it is difficult to research the safety of supplements on young babies and children.
It is important that babies and children under 18 only take supplements designed for children. Always check the label and adhere to directions.
Menopause & the Elderly
As you age, your metabolism and the way your body processes nutrients and other substances changes. It is therefore important that you look for supplements that are specifically formulated for your age group. For example, female multi vitamins often come in 3 different formulations, one for pre-menopausal women, one for during pregnancy and breastfeeding and one for post-menopausal women. This is because the requirements for each nutrient are different during these different lifestages, for example iron is not included in post-menopausal multi vitamins, due to the absence of a monthly bleed where iron was once lost.
In addition to this older adults are also more likely to have chronic conditions that require medication, increasing the risk of adverse interactions.
Pre/Post Surgery
If you are scheduled for surgery your surgeon will check what medications you are taking. It is just as important to tell them about any supplements you are on. You might be told to stop taking them for a while before they operate and during recovery. One common example, is Omega 3 supplementation that acts as a natural blood thinner.
Taking Medications, Supplements or Herbal Remedies
Some supplements, even the common ones, can interact with medications and other supplements or herbal remedies. They can have an additive effect by this I mean that the supplement and the medication could both be doing the same job. For example, the medication Wafarin is used to help thin the blood and is frequently prescribed to prevent clots. If someone taking Warfarin was to then take a supplement containing Omega 3, vitamin E or garlic, which all naturally help to thin the blood, it could lead to excessive bleeding. Conversely, if they were to take a supplement containing vitamin K it could increase their risk of blood clots.
While with some interactions it can cause an additive effect and put you at higher risk of toxicity others pairings can lead to reduced efficiency, preventing what you are taking from doing its job. For example, supplements containing calcium and/or iron can both interfere with the absorption of thyroid medications, reducing their efficiency, which could lead to poor thyroid function; and magnesium can impact the absorption of certain antibiotics, reducing their ability to do their job, such as fighting an infection.
This does not mean that you cannot take supplements alongside other medications, supplements or herbal remedies, it just means that you need to know when and when not to take them. Your healthcare practitioner, such as your GP, Pharmacist, Nutritionist or Herbalist will be able to advise the best way to take them safely.
Health Conditions
If you have a health condition, such as, cardiovascular diseases, diabetes or thryroid imbalances it is important that you take supplements under the guidance of a healthcare provider, such as, your GP or Nutritionist. This is for a number of reasons including, interactions with medications (see above) and the additional demand put on organs or systems within the body that are struggling.
Allergies & Intolerances
Some supplements contain allergens such as gluten, soy, or shellfish, which can trigger reactions in sensitive individuals. Most reputable brands will have allergens marked on their packaging and have advisors available for you to speak to.
However, it isn't just the main allergens that you should look out for, many supplements, especially cheaper and poorer qualities ones contain excipients, such as fillers and flavourings that some people can react to.
Smoking, Recreational Drugs, Alcohol & Caffeine
The final group of people we are going to look at within this post, with regard to supplementing safely, is those who smoke, take recreational drugs, drink alcohol or consume caffeine.
Smoking
There are certain supplements that you should be cautious of if you smoke, for example vitamin A, C, E and B9 (Folate). While you can consume foods and drinks that contain these vitamins, it is advised that you speak to a qualified Nutritional Therapist before taking any supplements. This is because smoking can interact with them in ways that are potentially harmful. For example, increasing your risk of certain types of cancer, such as lung and prostate cancer.
Recreational Drugs
There are a number of reasons why someone who currently uses, or has previously used recreational drugs, should only take supplements under the guidance of a healthcare practitioner who specialises in this area. The supplement could interact with what you are using, have an unwanted stimulatory effect and could cause unwanted behavioural changes.
Alcohol & Caffeine
Both alcohol and caffeine have the ability to interact with different supplements and medications, potentially slowing down or speeding up how they work, as well as impacting their metabolism, absorption, or effectiveness.
It is advisable that you avoid both while taking supplements or medications and if you do enjoy a coffee, tea, chocolate, or glass or two of wine etc., have them as far away from one another as possible. You can ask your pharmacist, Nutritionist or Herbalist to run an interactions check and advise you on how long you should leave between consuming them.
How much should I take?
Unless you are qualified to do so, you should always follow the instructions on the packaging of the supplement. You can contact the supplement company directly if you have any concerns or questions.
Healthcare practitioners may at times recommend a higher dose, also known as a therapeutic dose, for a short period of time to address a specific health concern or to achieve a desired therapeutic effect. The aim of this will be to restore specific nutrient levels quickly, helping to correct deficiencies and manage symptoms. For example if a blood test shows that you are deficient in Vitamin D you might be recommended a therapeutic dose which is much higher than the usual recommended daily intake.
Determining the correct therapeutic dose depends on various factors, including your age, weight, overall health, and the severity of the deficiency or condition. Your healthcare provider will tailor the dose to your needs. Once the desired therapeutic effect is achieved, your practitioner will reduce the dose to a maintenance level and recommend changes to your diet and lifestyle to help prevent the deficiency or condition returning.
Can you take too much?
Yes! Just because a supplement contains health supportive nutrients it does not mean you should aim to take as much as possible. For some nutrients (mainly water-soluble nutrients) taking too much would results in expensive wee, as the body will only take in what it needs. While for other nutrients (especially fat-soluble nutrients) taking too much can results in toxicity as the body is unable to safely utilise and remove it from the body leading to negative side effects.
For example, excessive amounts of vitamin D (fat-soluble) can lead to excess calcium in the blood, which could result in nausea, weakness, and kidney damage. While, excessive amounts of magnesium (water-soluble) can lead to diarrhoea, nausea, and in severe cases, heart problems. We will take a look at which vitamins and minerals are fat vs water soluble in our next blog post, so keep an eye out!
Working alongside a Nutritionist and testing your nurient levels regularly will help you to check that you are getting the right amount of nutrients that you need. Your healthcare practitioner will be able to recommend appropriate tests and help you interpret the results and adjust your diet and supplement needs accordingly.
When should you take them?
Certain supplements are best taken at certain times of the day. For example the following nutrients are best taken:
In the morning
Multi vitamins, vitamin D and probiotics are best taken in the morning as this is when they are likely to be best absorbed, and have greatest positive impact.
Iron (if needed) should be taken in the morning on an empty stomach, and away from calcium rich foods. However, it can be taken with a small snack if it causes stomach upset.
B vitamins, and CoQ10 should be taken before or at lunchtime as they have the potential to boost your energy levels. Taking them too late could interfere with sleep.
In the evening
With meals
Taking Fat-Soluble Vitamins (A, D, E, K) and fish oils (Omega 3) with meals containing healthy fats improves their absorption.
Away from meals
It is therefore important that you do your research or speak to a qualified nutritionist to make sure you are taking any supplements safely and that you are getting maximum benefit from them.
How to stay safe when taking supplements
Follow the recommendations on the packaging
If you are self prescribing always follow the directions on the packaging. How much, when and how you take a supplement, what you eat or drink alongside it and even how it is stored can have an impact on how efficiently it works.
2. Take note of the potential side effects
It can be all too easy to take a medication or supplement and two weeks in become aware of a new symptom, such as a rash, poor sleep or headaches. You then put this down to other things, such as what you are eating or a work deadline as you have not been able to trace it back to the new supplement that you are taking.
Take the time to check in with yourself every few days when you start taking a new supplement or medications and take note of any changes.
3. Choose reputable brands & check the ingredients list
Though a supplement may claim to be therapeutically active, the nutritional component (the bit that you want to optimise your health) can be as low as 2% of its total content! The other ingredients are inactive and are called excipients. Some of these are needed in the manufacturing process whilst others, especially in less reputable brands, are used to pad out the contents and maximise profit margins.
This highlights the importance of reading labels carefully (as we should with anything we put in, or on, our body). Always check the list of ingredients, not just the nutrients, research unfamiliar excipients and opt for reputable brands known for rigorous testing and transparency.
4. Inform your healthcare provider & check for interactions
Always inform your healthcare provider of the supplements that you are taking and every time you start taking a new supplement, you must take responsibility and check that it will not interact with something else you are already taking. You can check this with a Pharmacist, Nutritionist or Herbalist.
5. Test regularly
Where possible it is recommended that you test your levels regularly when taking supplements. While this is not possible for every nutrient, there are certain ones, such as Vitamin D and Iron which you can easily test at home, for example, every 3-6 months.
We highly advise that you speak to your healthcare practitioner (e.g. Nutritionist) before doing tests at home as you may just end up with results that you do not know how to safely and properly interpret.
6. Beware of health claims and misleading marketing
The rules around what you are legally allowed to say or claim varies from country to country. Companies will do all they can to market their product in the best possible light and will frequently make claims that are misleading. For example, this product contains 'natural ingredients' or is vegan. Just because a product states that it is made from natural ingredients or is vegan, does not mean that is a good product. Lead is a natural ingredient but it is certainly not good for your health. In addition to this, just because a product contains a certain nutrient or substance, it does not mean that the dose is high enough to have a therapeutic effect.
Read the product labels, check the claims for yourself, look at their websites, see what nutritional and scientific experts they have on their team and finally pick up the phone and talk to them; reputable companies will be happy to answer your questions.
7. Only take it for as long as necessary
If you take a supplement for longer than you need it, this could cause unwanted side effects and be a waste of your money. Your healthcare practitioner (e.g. GP or Nutritionist) will advise you on how long to take a supplement based on your health goals and condition.
Alternatively, you can contact the supplement company directly and speak to one of their advisors. Just make sure that who you are speaking to is a qualified healthcare professional and that they know what health conditions you have and what medications, supplements and/or herbal remedies you are currently taking. In most cases, nutritionists recommend supplements for 4-6 weeks before they reassess and decide if you should continue them for the next 4-6 weeks.
6. Focus on your diet and lifestyle first
And finally, do not take supplements unless you need them! Always look to improve your diet and lifestyle first. There is no point taking a supplement that has potential risks and costs you money when it is something that can be supported with simple diet and lifestyle changes. If you want to know how to get started with optimising your diet, check out our online course 'Nutrition: The Corner Pieces' where Nutritional Therapist Josie Shillabeer will guide you through the foundational information that you need to know how to optimise your diet.
Other things to think about
Before buying a supplement there are a few other things that you should think about.
What form do you prefer?
Supplements come in many forms for example capsules, liquid, jellies and even topical applications. This is helpful to know as you can decide which you will find easiest to take, and which will have the greatest impact on your health.
2. Can you swallow supplements?
Before you purchase a capsule or tablet based supplement have a look at how big it is, do you think you can swallow it comfortably? If the answer is no you can either look for a smaller alternative or you can have a look to see if the supplement can be crushed or sprinkled onto food. It is however very important that you check that the supplement can be crushed or broken safely. This is because some supplements will become ineffective or at worst dangerous when they are no longer in the form that they were originally intended.
As you can see there are lots of factors that you need to think about before buying or taking a supplelment. If you don't feel confident in making a safe and informed decision about what to take, how much, when to take it and for how long, it is best that you speak to a healthcare practitioner. Healthcare practitioners (e.g. Nutritionists & herbalists) are trained to help you select safe, therapeutic grade supplements that will support you to reach your health goals.
In our upcoming blog post we will take a closer look at vitamins and minerals, what are they, why you need them and how to optimise yours!
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