Ask a Nutritionist: Are supplements really necessary?
By Nonie DeLong, ROHP, CNP
Dear Nutritionist,
I enjoy your column and would like your opinion on supplements. I know a holistic nutritionist who advises against using supplements because she says food should be all we need if we eat right. But I know you have mentioned using supplements and I know many people do. My mother-in-law saw a naturopath and is taking a lot of supplements now. So, I want to know are supplements necessary? If so, how can we be sure they’re safe?
Thank you!
Kat
Dear Kat,
Your friend is not wrong. Our bodies are designed to get all our nutritional needs met through natural, unprocessed biologically and anthropologically optimal, organic food, in addition to unfiltered sunlight, fresh air, and pure water. Those are the building blocks of perfect health.
The problem is, we don’t live in a world where most of us have regular access to those fundamentals in an unadulterated form. Our foods are genetically modified (unprecedented in human history) or sprayed with ever more harmful toxins and grown in more and more depleted soils; our livestock are despicably abused and fed food that is biologically unfit for them; our water is contaminated by hundreds of chemicals that have never been tested together for their potential to damage human health; and our air is increasingly polluted from the byproducts of industry.
Thus, not only do we have limited access to high quality, nutritious foods in many parts of the world, our bodies now have far more toxins to process than they historically did.
Those that do have regular access to natural, organic food and clean water are increasingly confused about what constitutes a biologically optimal diet. More and more in the West we are tempted by highly processed ‘food products’ pushed at us by slick marketing that would have us believe these factory-created Frankenfoods are healthier than those that simply go from farm to home kitchen to table.
So, in a perfect world, yes, organic food grown in healthy soil, in its natural or home processed state, is enough for optimal health for most people who do not suffer congenital health issues. And in that case, people would not need nutritional supplements.
But when you factor in all of the toxins in our food and water supply today, the depletion of the soil that produces the food, the abuse of the animals that serve as food, as well as all the stressors of modern life, the body’s need for nutrients has exponentially increased at the same time as our crops and animal products have decreased in quality.
So, most of us just don’t get the nutrients we need for optimal health (disease prevention) from the food that is available today.
Most of us benefit from supplementation that is targeted, in addition to learning how to make healthy food and lifestyle choices. What do I mean by targeted supplementation? I mean monitored and directed by a professional who knows how to track symptomatology and use lab testing to determine imbalances. I have people say, “Oh, I get tests from my doctor and I have no deficiencies. But when we investigate what was tested it was sometimes D and maybe iron or folate and B12 and cholesterol levels. But there are hundreds of nutrients we need for optimal health! And it’s more complicated than deficiency = supplement.
Knowing that B12, folate, and iron are all low does not mean the person needs to supplement necessarily. It can mean they have low stomach acid and are not absorbing the nutrients, or it can mean their diet is seriously lacking in these key nutrients. It can also be due to acid blockers that the client takes, or other meds, or skewed levels may be due to a genetic problem with methylation, which only specific testing reveals. In such cases, very particular forms of the vitamins can be indicated. So investigating the diet in tandem with an assessment for imbalances is essential.
Testing not only reveals areas of depletion, but also areas of excess and imbalance. A person with high copper levels, for example, has low zinc, even if it doesn’t show, because one displaces the other and thus zinc shows in the hair not because it is high but because it is being displaced. And a zinc blood level does not tell us about this. Only a hair assay is accurate. These are things it takes practitioners years to learn and master. The time you spend in the office of a skilled orthomolecular nutritionist is only a fraction of the time they spend figuring out what is going on in your case and how to best address it.
There are also situations where levels of certain nutrients cannot be accurately measured by blood levels because they are circulating, but not getting into the tissues – which is usually because they are not being converted into the useful form to be taken up, as thyroid patients well know. In such cases, high blood levels may actually indicate tissue deficiency. In order to use nutrients, they need to be in the proper form, delivered to the appropriate site, and accompanied by any cofactors that help take up the nutrients into the cells. Carrier molecules may be missing, or enzymes, or the permeability of the cell may be damaged from a diet high in trans fats. On top of this, an organ may be stressed and requiring more-than-usual levels of any number of nutrients to function optimally. In these cases, the symptomatology will suggest deficiency while the testing may not.
Over time, taking high doses of any particular supplement can impact and even imbalance other nutrients in the body, so long-term high doses must be supervised. You may not think something is a high dose, but some nutrients are only needed in micrograms per day. And some people need very little of certain nutrients while others need a lot, which can only be seen by knowing the associated symptomatology. Only a qualified practitioner knows how to identify and direct this.
And people do not seem to understand that doctors are not properly qualified to give nutritional advice. They do not study it for any length of time unless they add a specialization to their degree, like functional medicine or naturopathy or nutrition. In such cases, they usually advertise this because it changes their practice considerably. Likewise, I am not qualified to give prescription drug advice or to diagnose disease – that is something only a doctor is qualified to do. We each have our particular scope of practice.
The difference between an orthomolecular nutritionist and a holistic nutritionist is the clinical application of supplementation. A holistic nutritionist does not typically direct therapeutic dosing (higher than label values) of supplements. Orthomolecular nutritionists generally do. The background of orthomolecular medicine is high dose vitamin therapy for the correction of underlying nutrient imbalances that lead to disease states.
Notice I didn’t say cure. Nothing you put in your body cures any health condition and anyone who claims a product does is not operating within the law. It’s illegal to claim any product can cure any disease. The truth is, the body overcomes disease itself when it has all the correct nutrients to do so in an environment that is conducive to that, when the body’s systems are strong enough to do what they are meant to do. That is why holistic practitioners li desire get to the root of the imbalances – to determine what it is the body needs to be effective in its own healing and self-correcting work.
You don’t need to worry about safety. The safety of vitamin therapies is well established, especially when compared to the dangers of pharmaceutical drugs. It’s extremely rare to hear of occurrences of overdose on supplements and the person has to be exceeding the recommended dose for a good length of time. And these need to be fat soluble vitamins (of which there are only a few) because water soluble ones get excreted by the body instead of accumulating in the tissues. If you take too much of the water-soluble vitamins you just get loose stools or expensive urine, but no toxicity state develops. The body is ingenious in itself correcting systems!
For those wishing to understand the history of orthomolecular medicine better, you can learn about it and the founder, Dr. Abram Hoffer, here. I came to learn about it when I took my young son to see Dr. Hoffer and he used vitamins and food to turn his health around, such that his symptoms and diagnosis changed! Hence, the beginnings of my trip down this rabbit hole!
As always, if readers have their own health questions, I welcome them. Feel free to reach out through the Ask a Nutritionist page. And if you’re looking for more specific health information check out my website and sign up for my free newsletter at hopenotdope.ca. I provide comprehensive health coaching and several group classes, all available online for safety and convenience.
Namaste!
Nonie Nutritionist
