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  • Dan Connors

Dietary supplements and the wild west of healthcare- 10 things that could make a difference


"To me, supplements are a necessity, not a luxury. I think of them as medicine: Instead of asking a doctor to prescribe me a drug when I'm ill, I'd rather take something that can help me avoid getting sick in the first place." Laird Hamilton

"Nutritional supplements are meant to complement a healthy diet, not replace it. If you're generally healthy and eat a wide variety of foods, you probably don't need nutritional supplements." Mayo Clinic


Americans spend over $30 billion dollars on dietary supplements every year. And it's often money well-spent, given how poor our diets and general health situations are. The goal is to eat healthy and live a healthy lifestyle, but the standard American diet is highly processed to make it more palatable, leaving a lot of the nutrition out. The problem with the supplement marketplace is that it's is mostly unregulated. Anybody can put anything out there without prior approval, and no one knows for sure what works and what doesn't. Doctors tend to shy away from recommending supplements, instead relying on the $400 billion pharmaceuticals marketplace to treat conditions. Health insurance policies don't cover them, and health savings accounts don't either. Why is this? Why do we spend more on treating diseases and maladies than preventing them in the first place?


My bullshit detector goes off regularly these days while watching commercials for this and that wonder drug that promises to help people go skydiving, play with grandchildren, or just smile all the time. It amazes me that people can disregard all of the serious side effects that these commercials are required to disclose, read while smiling, healthy, and attractive people are pictured. (another reason why we are much more visually oriented than auditory.) The USA is one of only two countries in the entire world that allows drug companies to to direct marketing, (New Zealand is the other one), while charging Americans more for their drugs than they charge elsewhere. It feels like a big scam. But are supplements even worse?


I decided to do some digging on supplements, some of which I've regularly taken, to see what the experts say. For this examination I relied on four sources- The National Institutes of Health, Mayo Clinic, Consumer Reports, and Web MD. Because supplements and vitamins can't be patented, there's not nearly as much money to be made by advertising them widely, and there's not much research money to do studies on what works and what doesn't. We are in the dark here, trying to figure out the good options from the bad ones, and I have no illusions that the companies involved are any more ethical than the drug companies. Bullshit detectors on high.


That said, let's look at ten popular dietary supplements in the market today. The standard warnings exist- check with you doctor about how most of these will effect you specifically, follow recommended dosages on the bottle, and buy from legitimate sources. And my disclaimer- I am not by any means a medical professional, so take everything I write here with a grain of salt. That goes for anybody who is not a medical professional and makes grand claims about benefits- take them all with a huge amount of healthy skepticism. And sadly, even medical professionals aren't immune from greed, hype, or disinformation (see Dr. Oz for examples). Here we go:


Vitamins


I've been taking these since I was a little boy, and I imagine they've probably helped me considering how lousy my diet and nutrition got at various points. Vitamins are not a substitute for a healthy diet, but they can sure fill in the spaces. There are many types of vitamins- chewables for kids, regular multivitamins, and "mature" multivitamins for people over age 50. There are even different blends for men and women. Every human body has different needs, so it makes sense that the vitamin folks are adjusting their blends for certain situation.


In addition to most of the popular vitamins like A,C,D, and E, multivitamins have minerals like calcium, zinc, copper, and magnesium that our bodies also require. Makers claim that multivitamins can help with general wellness as well as heart health and cognitive function, and the science behind how the different vitamins work inside the human body is pretty well-established.


All of my sources say that in general, multivitamins are okay to take and possibly beneficial for those with vitamin-deficient diets (most of us). The main downsides are that it is possible to overdose on vitamins and damage one's body, so they caution folks to be aware of the recommended doses and not go too far over. Also, multivitamins can't do it all. Many Americans are deficient in Calcium and Vitamin D, and pills can't replace the essential ingredient of fiber. Calcium is necessary for strong bones and needs to be supplemented through diet or calcium supplements for some people. Vitamin D is produced by exposure to sunlight, but in areas where that is minimal, supplements are helpful to those who test deficient (some 40% of Americans). Fiber we will discuss below.


Fish Oil


It's been long observed that diets rich in seafood are healthier for the heart than those from standard farm animals. Seafood contains high levels of Omega-3, a fatty acid that helps tame inflammation and has been linked with a variety of benefits including heart, brain, eye, and mental health.


Since fish is still not a basic part of most diets in the US, people have turned to fish oil tablets- concentrated doses of this valuable substance in a dissoluble capsule. While cooked fish can have a strong taste, these supplements go down with a glass of water, making them easy to take. They even make a version for pets.


I've been taking fish oil for decades, though I hear some people with seafood allergies don't tolerate it well. The benefits are well-established for taming inflammation, which has a long-term negative effect on all areas of health.


One problem with seafood today is levels of toxic mercury that have been found, especially in ocean fish. Fish oil supplements have been tested and have been found to contain negligible toxins, making them safer than many types of seafood. But it still is possible to overdo it with fish oil and there are side effects of overdosing, so follow recommendations and use reputable companies.


Turmeric


Turmeric is a spice that's been commonly used in Indian and Asian cooking. It has a yellow color and strong taste, so a little goes a long way. Westerners have discovered many beneficial properties of turmeric, and it's becoming a popular supplement, either in raw spice form or in pill form.


A relative of the ginger plant, turmeric has been used in Oriental medicine for centuries. It acts to combat free radicals in the body, which from my chemistry days are tiny junk particles that do damage to cells inside of the body. Benefits according to Web MD include easing depression, fighting infections, lowering cholesterol, easing joint pain, calming headaches, preventing diabetes, and resisting inflammation. By helping limit inflammation, it's touted as potentially a cancer and Alzheimer's prevention tool as well.


The active ingredient in turmeric is curcumin, which is a very unstable compound, so one issue is that very little of it gets absorbed once consumed. Experts recommend combining turmeric with another spice, black pepper, which somehow increases absorption rates of this helpful but volatile compound.


Fiber Supplements

(Metamucil, Benefiber, Psyllium, Athletic Greens, Garden of Life, Metagenics and many more.)

The standard American diet is tasty, but all of the processing has stripped out much of the fiber, or roughage that normally occurs with fresh foods. Fiber is not something that gets absorbed by the body, but it plays a big role in the digestive tract, helping to push foods and waste products along and out. The lack of fiber in most foods has been linked to colon cancer and constipation, and it's an important ingredient that often gets overlooked.


Foods that are high in fiber include beans, broccoli, whole grains, popcorn, apples and anything that takes a while to chew before going down your throat. To make up for a fiber deficiency, there are many fiber supplements on the market that do the job just fine. The side effects of too much fiber- loose stools- can be managed by adjusting fiber intake, so there appears to be little downside to these supplements other than the cost.


Fiber also is believed to help with weight loss, if only because people feel fuller and less hungry after eating fiber-rich foods. Colon cancer rates have been on the increase for decades, especially among younger people, with poor diet and obesity being the main suspect.


Weight Loss Supplements

(Green tea extract, apple cider vinegar, guar gum, garcinia cambogia, Alli, green coffee bean extract, caffeine and many more)


Obesity is a major problem that increases most health risks- heart disease, covid, diabetes, cancer, arthritis and many more. It's estimated that some 40% of Americans are obese and another 25% are overweight, mostly due to sedentary lifestyles and diets high in salt, sugar, and fat. This isn't new, and it's been a growing problem.


Because of the huge numbers and high importance still placed on youth and good looks, you can imagine that there are a lot of bogus supplements and diets that promise miraculous weight loss. There are just too many to go into here, so do your own research if you are looking to lose some weight with the help of dietary supplements. From what I can read, the effect of most of them is fairly minor- just a few pounds in most studies, but for some those few pounds may be worth it.


The best thing that supplements can do is to help control hunger and make you feel full. There have been dangerous ones like ephedra that had to be pulled from the market once the downsides were noticed, and there may be more dangers out there that we don't know about. Obesity is a lifelong condition, and anyone embarking on a weight loss plan must realize this. Hunger and craving control is key, and supplements may be of some help, but be aware that stopping them at any time could result in gaining back all of the lost weight and then some.


Probiotics


Humans have trillions of tiny bacteria that live inside of their intestinal tract, known as the gut microbiome. This little-understood ecosystem of good and bad bacteria can make the difference between health and sickness if it gets out of balance. These imbalances have been linked to not only intestinal issues, but also to autoimmune diseases, and to the immune response in general.


Helpful bacteria can be found in a variety of foods, including yogurt, kefir, kimchi, raw apple cider vinegar, onion, garlic and sauerkraut. For those who prefer, probiotic supplements are available on the market, though their quality and helpfulness is up for grabs. As the NIH warns "we still don’t know which probiotics are helpful and which are not. We also don’t know how much of the probiotic people would have to take or who would be most likely to benefit."


All that we really know is that there are a wide variety of these tiny bacteria, and we have them from birth, (mostly from our mothers), and then add to them as we eat, drink, and breathe. These bacteria have a huge effect on how we digest food and protect ourselves from infections Humans have evolved for centuries to create this gut balance, and it remains one of the final frontiers of medical research to figure out how it works.


Mushrooms


Mushrooms have been used in Eastern medicine for centuries, and their medicinal benefits make them a popular food and supplement. While some mushrooms are poisonous, most are not, and make an excellent addition to any salad, sandwich, or meal. Mushrooms are a good source of Potassium, Vitamin D, and ergothioneine, an antioxidant that helps the immune system function.


Mushroom supplements come in capsule form and combine a variety of mushrooms believed to be helpful with cognitive function, mood, energy, and immune function. Supplements usually mix several varieties of mushroom together, as each variety is known for different health benefits.


- Lions Mane- believed to help with brain function and cognition

- Reishi- for stress relief and healthier immune systems

- Turkey Tail- Liver and immune protection

- Cordyceps- Energy boosts

- Shiitake- tasty, nutritious, and immune system boosts


Of course, you can cook these mushrooms with your daily diet, though some can be hard to find at the local grocery store. Health food stores are more likely to stock them, or you can look for the supplements and pay more for them.


Resveratrol

For many years it's been observed that nations where wine drinking is higher, heart disease is lower. Consuming red wine in moderation is thought to lead to fewer heart attacks, though why that is remains unknown. (Because wine contains alcohol, consuming too much of it brings on different health risks and problems associated with that.)


One of the ingredients of red wine, resveratrol, has garnered a lot of attention and is thought by some to be an antioxidant that helps protect the lining of heart vessels. Resveratrol comes in supplement form, usually in capsules, and promises to have the same effect without the wine consumption. While the Mayo Clinic remains cautious about the benefits of this supplement, Web MD appears to strongly recommend it with demonstrated positive effects on cancer, cardiovascular disease, diabetes, and Alzheimer's disease. This is another one that probably should be taken with care, consulting a doctor and coordinating with risks for heart disease especially. Or you can just drink the red wine, but remember to drink it in moderation.


Nootropics and Brain supplements

Prevagen, Focus Factor, Ginkgo Biloba, Neuriva, Caffeine, B-Vitamins, Fish Oil, L-Theanine


Nobody understands how the brain works, so this is truly the wild west of dietary supplements. As the baby boom generation continues to age, more and more seniors are concerned with the cognitive decline that comes with it. More and more people are turning to nootropics, which is a blanket term for supplements that claim to enhance cognition. Specifically, they claim to improve memory, focus, mental energy, and problem-solving skills.


This field includes popular plants thought to enhance the mind, like ginkgo biloba and ginseng, and the data on those is pretty discouraging from what the experts say. There are many popular brands like Prevagen and Focus Factor that claim to improve mental abilities, but there are few large studies and Consumer Reports, NIH and Mayo discourage their use.

The most popular nootropic may be one that's in almost everything we drink- caffeine- but it comes with its own list of side effects and should be used in moderation.


Web MD points to a few promising ingredients like L-Theanine, while other items from this list- resveratrol, fish oil, vitamins, and turmeric all have been linked with cognitive improvement. Meanwhile, fish, leafy vegetables, nuts, blueberries, and dark chocolate have been seen to help cognitive abilities as well. And of course there's also the more important ingredient of social contacts and active learning experiences to keep the brain and mind healthy.


Nicotinamide Mononucleotide (NMN)


NMN, as it's commonly called, is a new and obscure supplement that's barely known about because it's still being researched. I learned about it from Dr. David Sinclair's book, Lifespan- Why We Age and Why We Don't Have To. Sinclair is no Dr. Oz- he a is professor in the Department of Genetics and co-director of the Paul F. Glenn Center for the Biology of Aging at Harvard Medical School. He takes NMN every day, and provides details on how it's proven to help with the symptoms of aging.


Mayo Clinic and Web MD have little to say about it, but NIH has this article, that concludes " NMN is clearly a murine fountain of youth. But what about humans? Shin-ichiro Imai has said that NMN may improve adult human metabolism, rendering it more like that of someone ten or twenty years younger. His team is now studying NMN in humans."


NMN is a naturally-occurring molecule and a precursor to NAD+, a coenzyme that’s central to various cell functions including metabolism. As you age, your NMN levels decline, which means your body makes less NAD+, which may contribute to age-related health conditions like cancer, heart disease, and diseases like Alzheimer’s.


Slowing the aging process protects you from all sorts of health consequences, and it's hard to believe that big pharma hasn't monopolized this one yet. This is one to definitely keep an eye on, and it's available for purchase now.



There are many, many supplements out there making substantial claims, and there's very little accountability or oversight in the supplement marketplace. There are so many other supplements that I haven't covered- CBD, Melatonin, Aloe Vera, Sawgrass Palmetto, Glucosomine, Flaxseed Oil, St. John's Wort, and the dozens and dozens of proprietary blends that claim to cover multiple ailments. Supplements are a huge marketplace, with so many unknowns but so many possibilities.


Still, for basic health maintenance I prefer to consider supplements for four main reasons:


1- I know that my diet is not so great, but at my age changing it is a struggle, especially with all of the temptations that are everywhere. This is the least that I can do to try to even up the score for my nutritional shortcomings.


2- Because of the enormous amounts of money at stake with Big Pharma, (and the annoying commercials), I don't trust them. Doctors take money from pharmaceutical companies, and the opioid epidemic exposed the Faustian bargain at the heart of it all. That said, you can't write prescription drugs off completely because they are extensively studied and regulated. When possible, I would rather spend my meager funds on prevention instead of proven things even if my insurance won't cover them.


3- Modern medicine excels in several areas- preventing infectious diseases, fixing up broken bones and organs, and treating major diseases like diabetes, heart disease, and cancer. For the rest of lifestyle-driven healthcare, it falls way short. Many doctors, limited to 15 minutes with each patient by insurance companies, rarely ask about dietary habits, mental health, sleep habits, or supplements. They have pharmaceuticals and surgery as their main training, and they mainly step in when symptoms get unbearable. Knowing that, it's up to all of us to fill in the blank spaces with preventative measures. (While still consulting with doctors and getting regular check-ups.)


4- There is a placebo effect that comes with any medicine or treatment. Believing that something will help you increases the chances that it will. This effect has been shown with almost any drug or procedure out there. Our minds are very powerful at influencing our health, and the combinations of endorphins and other hormones that our brain can control can make a huge difference. There still has to be some scientific validity behind taking a supplement, but the placebo effect magnifies its impact.


Preventative care is not glamorous. There are no television shows where doctors explain the importance of a healthy lifestyle. Medicine in movies and television is heroic and almost always successful, and it doesn't reflect what does or should happen. Into that void are thousands of snake-oil salesmen who prey on the sick and desperate, or who tout unproven weight loss products based on unscientific studies because there is money to be made. That doesn't mean we should give up trying to live healthier, but we have to be curious and vigilant in this wild west of drugs and supplements.


I make no assurances that any of the things discussed above work, but I have taken several of them and had no bad effects. I may never know for sure if they made a difference, but I like the odds that they do. And most of life is about playing the odds.


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