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Monday, December 10, 2007

The Supplement Game


photo by laura a

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In 2000, 17 billion dollars were spent on dietary supplements. The desire for a pill to solve all that ails us is pervasive in our culture. We want...no expect...some smart guy to provide the answer to all of our problems, for three small payments of only $19.99. To even begin to try to unravel all of the available supplements would be an monumental task. Instead, here are some supplements that seem to have a substantial amount of evidence that they can provide some benefit.


The common view of multivitamins is that they are a good "insurance" policy against vitamin deficiencies. As long as they contain vitamin and mineral amounts near the Recommended Daily Allowance, you should be OK. Again, these should only serve as a supplement to a healthy diet. If you are eating the recommended amounts of fruits and vegetables, you shouldn't need a multivitamin. If it makes you feel better, then take them.

Individual Vitamins

If you choose to take additional amounts of individual vitamins, be aware that you can have too much of a good thing. Your body can rid itself of excess water soluble vitamins (most of them) through sweat and urination. Be wary of excessive amounts of fat soluble vitamins (A, D, E, K), though. Large doses of these vitamins, especially Vitamin A, can accumulate in your body and cause headaches, vomiting, liver damage, coma, even death.

Fish Oil (Mayo Clinic)

Many claims have been made about the benefits of taking fish oil supplements. As with anything, these benefits are dose dependant...and remember, it the amount of the actual Omega-3 fats that cause the effect. Read the label on your fish oil supplement to make sure that you are taking enough to make a difference. Just because each capsule contains 1 gram of fish oil, doesn't mean that each capsule contains 1 gram of EHA/DHA. Read those labels! Here are some that "make the grade" according to the Mayo Clinic, as well as the dose of EHA/DHA needed to reproduce the effect in parentheses:

  • Reduces blood triglyceride levels (2 - 4 g per day)
  • Reduces risk of heart attack in those who have already had a heart attack (1 g per day)
  • Small reduction in blood pressure (2 - 5 mmHG) (>3 g per day)
The link to the Mayo Clinic also lists many other purported benefits of taking fish oil and details the strength of the evidence supporting those effects. Many things are listed, but the evidence is scant or non-existent for all but the ones that I've listed.


Very popular supplements to help with joint pain. Both supplements have been individually shown to help with osteoarthritis pain, especially of the knee. Glucosamine Sulfate is a component of cartilage and Chondrointin Sulfate is made from cartilage, so the popular reasoning is that they help rebuild cartilage. There is no evidence suggesting that taking these supplements will rebuild deteriorating cartilage. The effects seem to be related to these compounds having an anti-inflammatory effect.

Yeah, but this horny goat weed/siberian ginseng has cured my arthritis/bunions/irritable bowel syndrome? How do you explain that smart guy?

Well, is it the horny goat weed or the placebo effect? Would a sugar pill have had the same effect? Clinical trials use double blind studies where neither the researcher or test subject are aware of who gets the real medication or a sugar pill. In these cases, 30-50% of test subjects who receive the sugar pill report feeling better. Very few herbs, medicines, vitamins, or dietary supplements can do better than this. Medicines that can't outperform a placebo are shelved, but dietary supplements are not required to meet the same scrutiny. I guess if you can afford the supplement, it seems to help, and does no harm, it's okay for you, but that doesn't make it a panacea for everyone with your ailment.

If you choose to take supplements, remember that supplements are just that...SUPPLEMENTS. No supplement can undo the effects of a poor diet.


Thom said...

You are so right -- the key is to BE INFORMED.

There is too much misinformation, and too many consumers simply walk into a store, read a label, and think they know what supplements to take and for what support or condition. Get educated!

There's a great (and surprisingly unbiased) resource list over at the Dietary Supplement Information Bureau. It's worth checking out, and a better reference I've found than Wikipedia