Nothing gives me more anxiety than seeing someone's stash of 20+ supplements. What on God's green Earth is lurking in that medicine cabinet?? Many people (including myself at one point) consider supplements to be harmless. The typical attitude towards them is that maybe they won't work, but it can't hurt to try. Right?
My perspective on supplements has evolved considerably over the years. When I was a teen, I loved the concept that one special ingredient could potentially "cure" some common ailment. It seemed magical that an herb or vitamin could alleviate fatigue, brain fog, headaches, or even prevent cancer. In retrospect, it probably should have seemed magical because it certainly is not reality. The truth is that supplements should be used conservatively, just like medications. Like over-the-counter and prescription drugs, supplements can cause severe side effects and drug interactions. They can also be fatal.
I first learned that supplements can be deadly right before I left for college. At the time, I had been taking an SSRI for anxiety for over a decade. I was very much into natural remedies and was frustrated that I couldn't treat my anxiety disorder with more natural solutions. I hoped that with the "perfect" diet, regular exercise, yoga, and maybe some supplements, I could one day do away with SSRIs altogether. I came across a book written by a medical doctor that seemed legit. A book written by a doctor? It must be factual, right? The book recommended several foods and supplements that supposedly worked miracles for mental health. Before leaving for college, I purchased two expensive supplements. I was so excited to try them out. Ironically, I was a little bit anxious to try the supplements. At the last minute, I decided to email my psychiatrist.
My psychiatrist is lovely, but before this experience, I had found him slow to respond to emails. When he called me quickly after, I was surprised by his urgency. He explained that taking the supplements I had purchased was not a good idea. Firstly, the active ingredient in one of the supplements, 5-HTP, is not safe to take with an SSRI. Both drugs increase serotonin levels, and little did I know that too much serotonin can cause a potentially deadly reaction called serotonin syndrome. He explained that supplements are not regulated as tightly as pharmaceuticals, so each capsule/tablet's amount of active ingredient can vary from the amount listed on the label. Even if he prescribed a safe dose, the pill could unknowingly contain more than the packaging indicated. This experience did not necessarily turn me off from supplements, but it did encourage me to communicate with a healthcare professional before purchasing them.
My conservative approach toward supplements was bolstered during my college and graduate school education. I learned that even some of the most healthy ingredients could become harmful when taken unnecessarily. One well-known example is the detrimental effects of beta-carotene supplements when taken at high doses. Beta-carotene is a form of vitamin A found in plant foods. It often has a yellow or orange color, so people often think of carrots, squash, and sweet potatoes. It is also found in leafy greens like spinach (the green chlorophyll masks the yellow). It is a vital and safe nutrient when we obtain beta-carotene from food. It is essentially impossible to get too much beta-carotene from food. Because of its antioxidant effects, studies have investigated whether supplementing with beta-carotene can help prevent cancer. Researchers were shocked that individuals who took the supplement had a higher rate of cancer in some circumstances. Several studies confirmed that beta-carotene supplementation could increase the risk of lung cancer by 18-28% in those who smoked or had asbestos exposure.
My point is not to make anyone fearful of beta-carotene. Instead, I hope to convey that the "it can't hurt to try" attitude is flawed. Supplements should be treated with respect and taken only when necessary. They can be instrumental in some situations, and sometimes people's lives depend on them. I do not want anyone to think supplements are "bad," but rather, products to be taken seriously.
I often think of dietary supplements like cannabis and THC. Marijuana can be highly therapeutic in certain conditions such as epilepsy and cancer. Unfortunately, not all weed is equal. More progressive states have dispensaries with cannabis pharmacists. My cousin's husband is a cannabis pharmacist, and I was fascinated to hear about his job. He explained that his career ensures that each patient gets the correct strain and dose. For instance, an 85-year-old grandma does not need the same product as a college student looking for a chill Friday night or a child with unrelenting seizures. States with cannabis dispensaries can ensure that the marijuana is pure and is free from dangerous chemicals. Pharmacists can regulate the dose and provide advice on amount and strain.
In contrast, buying supplements sometimes seems more like buying weed from your brother's roommate's friend at a party. The supplements are probably fine. But as you peruse the shelf at Whole Foods, you're unsure how many milligrams of vitamin XYZ you should get. You don't know what brand is best. Furthermore, there's no guarantee that the bottle claiming to have 500 mg contains that much of the active ingredient. There's also a chance the supplement could be contaminated with heavy metals or unlisted ingredients. There is no equivalent to a pharmacist to ensure you purchase the right product. You are essentially on your own.
After reading this, it may seem like you should avoid supplements altogether, right? Unfortunately, there are many circumstances where supplements are necessary and helpful. In the world of fertility and pregnancy, supplements are essential. So what should we do? How can we supplement safely?
If you need to purchase a supplement, here are some tips:
-Third-Party Testing: Buy a supplement that is third-party tested. Third-party testing means that a separate entity tests the supplement and varifies the potency and purity. Consumer Lab, Labdoor, USP, and NSF are third parties that sometimes approve or verify supplements.
-Food First: Dietitians tend to believe that we should always prioritize food before supplements. If you want more beta-carotene in your diet, you should eat carrots, etc., before jumping to a supplement. This method is safer, and you benefit from all the other nutrients in that food. One comparison is breastmilk, which would be the "food" in this example, and formula, which would be considered the supplement.
Have you ever seen this graphic?
Even the best formulas don't have all the beneficial properties of breastmilk, just like a beta-carotene supplement doesn't have all the nutrients of a carrot. Although it is sometimes necessary to use formula or purchase a supplement, it is best to use these as alternatives. Supplements should be Plan B, and food should be Plan A.
-Professional Advice: Always disclose any supplements you are taking to your healthcare practitioners. This is medical information they need to know. I also recommend consulting a dietitian or physician when you need to purchase a new supplement. Try to speak with someone who specializes in the area of nutrition or medicine that necessitates you to buy the supplement. For instance, if you purchase supplements for IVF, speak with a fertility dietitian and reproductive endocrinologist.
We are so fortunate to have supplements available. We can prevent so many deaths and deficiencies by having supplements on hand. However, just like no one should aim to take 30 prescription drugs at a time, no one should aim to take 30 supplements. You will probably save a lot of money too!
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