Supplements are no substitute for food for being healthy.  The healthiest and longest living people on earth take little or no supplements. However there are some important supplements to consider in your journey for greater wellness. Supplements consist of vitamins and minerals, the micronutrients that our body needs for good health.  Some are actual foods like fish oil and herbs.

I often tell patients that “good health does not come in a bottle”. That glib comment is backed up by science.  With rare exceptions, high quality research looking at the use of vitamins and other supplements compared with just good food show that supplements do not add health benefits and may cause harm.

I like the expression of Colin Campbell in his book, Whole, that supplements confuse the body.  We evolved to eat the foods of nature, not to take a bolus of one or a batch of supplements in doses that are not represented in food.

Gerard Mullin in his book, The Gut Balance Revolution, uses the metaphor of food as a symphony.  He points out that using supplements is like taking a few musicians out of the symphony and asking them to play comparable music.  It does not happen.

There are some exceptions worth noting.  Evolution did not care if we lived past our reproductive years.  Vitamin D is a hormone like substance we manufacture from cholesterol  in our skin from sunlight.  Vitamin D is vital to many body functions, not just our bones.  It is not present in natural foods but is sometimes added to dairy products.  When we age, our skin’s ability to make vitamin D from sunlight wanes and many people over age 50 become deficient in Vitamin D even if they are in the sun. This is especially true of seniors over age 65.  Hence, Vitamin D is the one vitamin that should be taken by mature adults.  Vitamin D3 is the digestible form of Vitamin D and 2000 – 5000 IU should be taken daily.  This will provide an optimal level of Vitamin D in the blood between 40 and 60 (the normal range of Vitamin D listed in most labs is between 30 and 100).

Another supplement needed by many seniors is the mineral magnesium.  Seniors do not get as much magnesium from food as younger people and may have muscle cramps or restless legs, especially at night.  I recommend 400 mg of magnesium citrate every evening for seniors over the age of 70.  Some other forms of magnesium are not well absorbed.  Magnesium is a good laxative and taking too much will give you diarrhea.

Another supplement I take is a mixture of glucosamine, chondroitin and MSM.  These do not treat arthritis, but may have some role in preventing the loss of cartilage that leads to arthritis in our joints, especially the knees.  The necessary dosage is unknown and I take one of the readily available products that have these three ingredients as recommended on the bottle.

Vegans and some seniors especially over the age of 80 become deficient in Vitamin B12.  This can easily be tested for in a blood test.  If the need is there, take 1 mg or 1000 mcg of Vitamin B12 daily.  B12 shots are not necessary even for people who have pernicious anemia.

The use of fish oil for both cardiovascular and brain health is a hot topic and the research is mixed.  EPA is the fish oil for the cardiovascular system and DHA is for the brain health.  After years of resisting them I now take a combination of these two from a reputable supplier like Nature Made to avoid mercury contamination.  Eating healthy fish like salmon 2-3 times per week will supply you with plenty of fish oil making the supplement unnecessary.

I respect David Perlmutter, the neurologist author of Grain Brain and Brain Maker and Dr. Perlmutter on his website lists seven “super supplements” for brain health.  These are:

1. 1. The fish oil DHA (I take with EPA)

2. 2. Resveratrol (I have a glass of red wine most evenings)

3. 3. Turmeric (I take that as ¼ teaspoon daily as organic curry powder)

4. 4. Probiotics (I do not take these unless I am taking an antibiotic or have diarrhea.  I prefer prebiotics, the natural fiber in vegetables, nuts and whole fruit.)

5. 5. Coconut oil.  I take a teaspoon daily and fry my eggs in organic coconut oil.

6. 6. Vitamin D (as stated above.  I take 5000 IU daily)

7. 7. Alpha-lipoic acid. (I do not take this as yet).

For more information go to Dr. Perlmutter’s website: https://www.drperlmutter.com/grain-brain-seven-super-supplements/

Two anti-aging supplements I take are recommended by David Sinclair, PhD in his book, Longevity: Why We Age and Why We Do Not Have To (Atria Books, 2019):

Metformin 500 mg daily (may be taken twice a day) after meals.  Metformin is used for type 2 diabetes (usually at 1000 mg twice daily) and provides a longevity benefit that is not well understood.  Clinical trials are underway but the evidence is compelling enough to have me take it.  Metformin requires a prescription.  It does not cause low blood sugar and if taken with or after food intake usually does not upset the stomach.  I take it once a day in the evening but Sinclair uses it twice a day.

NAD (Nicotinamide adenine dinucleotide). Nicotinamide adenine dinucleotide boosts cellular energy and is an essential cofactor in all living cells that is involved in fundamental biological processes. Emerging evidence implicates that elevation of NAD levels may slow or even reverse the aspects of aging and also delay the progression of age-related diseases. To get NAD the supplement is usually NR (Nicotinamide riboside).  That is converted to NMR (Nicotinamide mononucleotide) to become NAD.  I take the NAD+ 300 mg product from Life Extension (lifeextension.com) that is actually NR making it more affordable.  A benefit of this product is that it also contains 100 mg of resveratrol.

Paul and Shou-Ching in their book Perfect Health Diet (2012) have a short list of recommended foods and supplements that are worth considering at: http://perfecthealthdiet.com/recommended-supplements/

Some supplements are food products such as saw palmetto and grape seed extract. In bottles these are very expensive ways to get a small amount of what is readily available in healthy foods. 

Forget that once a day multi-vitamin.  It will not prevent you from catching colds or getting sick.  Eat real health foods, especially the “Superfoods” as listed next.

I shun authors who promote lots of supplements and most of them have a conflict of interest since they sell them on their websites.  I strive to get my patients off an excessive list of expensive supplements.  Better to use your money to buy healthy food!

Joseph E. Scherger, MD, MPH

http://www.leanandfitlife.com