I fully admit I love learning about nutrition and supplements. It's one of my nerdier hobbies. I have seen both personally and professionally how supplements can do tremendous things, but over the years I have encountered a number of skeptics. I love people who are skeptical- if nothing else they afford me the opportunity to grow as a teacher, reflect and develop new insights and opinions. Here are a couple of comments I have gotten in the past and my responses to them.
1. What are the best supplements to take?
The long and short answer here is that there is no best supplement, no magic bullet. What might be good for one person may do nothing or harm another. Those of us in the alternative medicine field often forget that and like to think that our natural products can only do good, but that is not necessarily the case.
Granted, a downright negative reaction to a supplement is relatively rare, but it's always something that needs to be discussed prior to treatment. In order to do this and understand the possible side effects the practitioner needs to understand the physiology behind what they are giving you- how does the body absorb the product? How do different tissues use it? Knowing the pathways for how a product is used will give the practitioner insight (and predictive power) if those pathways are pushed a little too far. Sadly, not everybody who prescribes or distributes supplements knows these pathways, and therefore doesn't tell patients about the possible side effects or know how to handle them when they come up. A response I've heard more than once is one of blind faith- "Just keep taking it anyway. I know it's good for you".
The scenario I've heard far more frequently is that where the supplement made no noticeable change. Ask anyone if they've ever taken a vitamin or supplement and I'd bet 80-90% of them will say something akin to "yes, but it didn't do anything so I stopped taking it". This comes down to two issues that really can be rolled into one. If there is no objective measurement (blood, saliva, stool testing) to go off, two things happen. First (and most importantly), the practitioner doesn't necessarily know what your body needs. Yes, there are certain things (like neurotransmitters) that are difficult or impossible to measure, so you have no choice but to go off of the patient's history and exam, but that is not the norm. The second thing that happens is that the patient doesn't know (or understand) how or weather this supplement will actually help them. Without an adequate discussion and explanation the patient may not understand what changes to look for. To add insult to injury, I find that nonchalantly prescribing supplements decreases the value that the patients place on those supplements, and often times people take them sporadically or not at all.
The key with supplements is to
A. Get lab testing done and an exam to understand what your body needs- don't take something just for the sake of taking it.
B. Discuss the supplements (and medications) with a physician who is well versed in this topic
C. Take the supplements as they are prescribed and communicate with your physician as you notice changes, no matter how small
2. I don't believe in taking supplements. Our species has lived for millenia without supplements so we don't need them.
I believe this opinion often stems from people's previous experiences with supplements and vitamins. They, like so many others, have probably tried taking supplements and vitamins before, did not feel a change, and then dismissed that all supplements are worthless. Yes, some supplements are borderline worthless or can do harm, but that is exactly why I do lab work in my practice- so I can better assess what each patient actually needs.
The concept this brings up is an interesting one, though. Do we all need to take supplements every single day? On the one hand, supplements only became available to us as a species in recent years, which may indicate that they are unnecessary for human life. But if you think about it, people are living longer, much different lives than those of our ancestors. It's really not fair to compare the two. Years ago I'm sure people weren't eating PopTarts, sitting all day, taking multiple prescriptions, and being exposed to (the same) toxins we are now. I'm not saying everyone needs to take supplements every day, but I'm sure the relative need for such help has dramatically increased in the last hundred years.
Furthermore, while it's true that most of us can live without such help, that's not always my primary concern. Chronic diseases and poor nutritional status don't kill you immediately (thus, they are chronic) but can dramatically affect your quality of life. Yes, you can live without taking vitamin D if you are deficient... but your quality of life will most certainly be poorer. No, not everybody needs to take MTHF (the metabolically active form of Folate), but if you are one of the many who has an MTHFR SNP and can not convert Folate properly you can bet your bottom dollar I'm going to recommend you take MTHF for the rest of your life.
3. Dr. Oz said this is the most important thing everyone should take.
If you watch these types of shows regularly you'll notice a pattern: whatever they are talking about that day is the most important thing. You never hear The Doctors say "well, as exciting as this episode is, it's not as important as what we told you last month".. That wouldn't do much for ratings and would most certainly confuse the public. I've heard Dr. Oz state no less than 12 times that the supplement he talked about that day was "the most important for everybody to take" or "if I could recommend one thing for everyone to take". The confusion sets in when you realize that he's recommended about a dozen "one thing" products.
Moral of the story, don't take your advice from the TV or internet. Neither of these things can possibly be a substitute for a good physical exam, blood work, and open communication with a practitioner who knows what they are doing.