There is no absolute answer to whether or not supplementation is necessary, as it depends on the relative case. To err on the side of caution…no it is not always necessary to supplement. However, there are instances of when it is beneficial and people can benefit from therapeutic supplementation. Simply put, food is the foundation of wellness. Supplementation can be avoided for the most part with a healthy, well-balanced, non-inflammatory diet. Nonetheless, genetic tendencies, injuries, and other illnesses can benefit from therapeutic supplementation.
Another word for these dietary supplements is nutraceutical, and these terms are used interchangeably. A nutraceutical is a food-derived product with health benefits ascertained to that food. It is the combination of the Latin words nutrient and pharmaceutical. Although I currently work as a physician, I am really a scientist at heart. While studying biology, chemistry, and nutrition prior to naturopathic medical school, I had the opportunity to participate in undergraduate nutritional research. The supplements I recommend are evidence-based and scientifically proven to produce an effect.
Nutritional Deficiencies
Let’s talk more about food. Is everyone really magnesium deficient? Replace ‘magnesium’ with ‘mineral’ and you have a fair question. It is proven that fruits and vegetables today have less nutritional value than their ancestors. Several studies have found modern vegetation to have 15-35% less vitamin A, vitamin C, iron, and calcium when compared to the same plant values in the 1950’s. Other minerals (zinc, manganese, lithium, etc.) weren’t recorded in the fifties, but the trends are expected to be similar. The reason for this is related to modern agricultural practices. Today, vegetation is grown faster and larger, and the plants aren’t able to pull up the same amount of nutrients from the ground. The soil itself is not rotated with nitrogen-fixing plants, thus the soil doesn’t have a chance to replete itself. Additionally, pesticides have been found to sterilize the soil, which reduces the microcosmic ecosystem responsible for generating healthy soil. Not only is the average American eating suboptimal amounts of vegetables, but also the vegetables consumed are more deficient in vitamins and minerals than ever before. Minerals are an integral part of bones, ligaments, connective tissue, and act as cofactors in numerous enzymatic reactions affecting the nervous system, circulatory system, and the immune system. In a world where most processed foods are fortified with vitamins, minerals remain deficient in the standard American diet (SAD). Overall, this means Americans need to add even more vegetables to their diet preferably with each meal, and as snacks. Vegetables contain advantageous vitamins, minerals, fiber, and protective phytochemicals.
Therapeutic Supplementation
Therapeutic supplementation is the act of supplying a physiological system with specific compounds to produce a desired effect. However, it is never the first thing I do. Let’s treat the definition of supplement with respect: “Something that completes or makes an addition” (Merriam-Webster Dictionary). Supplements should be used to enhance a well-rounded lifestyle. Supplements should not be used as bandages for poor lifestyle choices. I will never tell someone it is okay to skip the vegetables and just take a multivitamin, this is not therapeutic supplementation. One can observe the ‘diet vs. supplements’ conundrum with the diabetic population. Patients wish to reduce their dependence on medication by trying a natural alternative. Of course, there are several botanical medicines that have the support of the scientific literature to decrease blood glucose; yet, if the patient is not ready to change what is in their shopping cart, these medicines won’t work to their potential.
With firsthand experience working at a health food store, customers would ask for advice regarding which supplement is best for various symptoms: headaches, back pain, sciatica, bloating, congestion, hair loss, etc. I’d begin by asking what type of food they consume. Customer after customer, I would stress the importance of elimination rather than supplementation; elimination of inflammatory food groups such as gluten and dairy. For instance, people would present with indigestion, bloating, and heartburn. Instead of recommending supplements, I would speak on considering an elimination first. Some admitted they couldn’t live without regular doses of pizza, and proudly purchased the supplement to ease their digestive ailments. I felt I did my job by explaining the cause of the problem, but in the end just provided an effective and natural band-aid. The bottom line is the customer did not have a ginger or fennel deficiency; rather, they had a dietary sensitivity promoting inflammation in the gastrointestinal tract.
This behavioral problem of not addressing the root cause repeats itself in all body systems. Hair loss is just another example. People are quick to think of biotin, a B-vitamin supplement to promote hair health. Hair loss can be associated with a myriad of problems on a spectrum of deficiencies to toxicities. Perhaps it’s heavy metal toxicity, hypothyroidism, genetics, microbial infection, age-related, hormone-related, or autoimmune disease. And each of these causes would then have to be dissected to detail if it is thyroid-related: is it iodine deficiency, gluten causing Hashimotos, is it stress and adrenal fatigue draining the thyroid? I always recommend a consult with a Naturopathic Doctor to evaluate for the root of the problem.
People often shop for supplements for various musculoskeletal pains. There are certainly supplements to help with pain, however you need to have a working diagnosis to properly and safely use supplements. Back pain can be a result of a number of problems including nerve, skeletal, or muscle pathology, but not excluding serious issues such as vascular disease or cancer. To blindly put all your trust in turmeric capsules is neither smart nor therapeutic supplementation. It would be advised to get orthopedic testing and perhaps imaging to further define what the problem is. From here you can manufacture a therapeutic supplementation protocol that may involve anti-inflammatory herbs, connective tissue tonics, or pain modulators.
I was once told there is no such thing as an aspirin deficiency headache; meaning, the headache is a symptom of a deeper problem. Ginger root, a botanical medicine supplement, has similar anti-inflammatory actions as aspirin (blocking cyclooxygenase-2 from creating pro-inflammatory agents known as prostaglandins). Ethically speaking, what are the differences between treating a headache with aspirin vs. ginger? We know aspirin is associated with stomach ulcers when used in excess, whereas ginger acts as an anti-inflammatory agent for digestion. However, there is no such thing as a ginger deficiency headache either. Finding the true cause of the headache is empirical: is it a food sensitivity, nutrient deficiency (magnesium, riboflavin), environmental toxicity (molds, detergents), or Lyme disease. If it is a nutrient deficiency or Lyme disease, then use smart therapeutic supplementation.
Therapeutic supplementation with scientifically proven products can be beneficial when trying to produce a physiological shift in one’s system. For example, alpha lipoic acid has repetitively been shown to reduce neuropathy symptoms. Fish oil supplementation has been shown to benefit heart disease and reduce blood triglycerides. Just this year, another study showed Echinacea extract is just as successful as Tamiflu® in reducing symptoms of influenza. This list can continue for pages. I stress that this information is offered not as treatment, but for inspiration to consult with a qualified practitioner. Doses will vary per person, and supplements are only one aspect of the complete treatment protocol.
In review, supplementation is not absolutely necessary if you are eating a whole-food based diet. When treating specific disharmonies, supplementation may be necessary and can be beneficial. Always consult a credentialed practitioner so close attention can be made towards symptoms and regular bloodwork can be done. Supplementation is not an outright answer to any problems; rather it is a part of a larger, holistic intervention. The purpose of this article is to guide and educate the consumer when considering supplementation. No material in this article is designed to diagnose or treat any conditions; rather, the material is to inspire the reader to work with a credentialed health care practitioner.
Dr. Nicholas J. Edgerton, ND, MS-Acu, is a naturopathic physician at Connecticut Natural Health Specialists, LLC. He is an in network provider for most insurance companies and is accepting new patients. For more information, please call (860) 533-0179 or visit: ctnaturalhealth.com.