The news headlines recently covered the issue of supplements after an American man needed a liver transplant following the consumption of green tea extract capsules. Dietary supplements is a massive industry, raking in billions every year. But are they worth it?
Jim McCants, an American who decided to take green tea extract capsules for heart health benefits and weight loss, had emergency liver surgery.
This prompted the headlines: Are supplements safe and do they work?
For some people, taking supplements could seriously damage their health if they have a medical condition they know nothing about.
An example of this is a genetic condition called haemochromatosis – considered by some to be more common than we know, simply because there could be so many people undiagnosed.
Taking iron supplements could be seriously detrimental to the liver for people who have a condition that does not effectively regulate how much iron is stored in the body, and therefore poisonous levels can be reached easily.
This is more true for men than women (during their menstrual years), because men can not shed excess iron unless they make themselves bleed.
Reactions from food supplements are rare, but happens. Supplements do not go through the same rigorous clinical trials as medical drugs do, because supplements are regulated by the The EU Commission Regulation, which issues directives on supplement advice based on advice from the European Food Standards Agency.
Medicines are regulated by the European Medicines Agency through the European Commission. This system is not hugely different in the US and other parts of the world where supplements are regulated by food agencies rather than medicines.
If we follow a balanced, well-planned diet, most of us generally don’t need supplements. But there is evidence now that the quality of our food just isn’t as it was.
This is largely due to nutrient loss in storage (a lot of our food travels large distances now so we don’t know how old food is before we consume it), changes in agricultural practices, increased reliance on manufactured food and less on home-cooking – all of which compounds to an overall poorer diet.
If you’re going to buy supplements, particularly from the Internet, you need to ensure that they are of good quality, and manufactured and tested to your country’s quality assurance for pharmacovigilence.
That is, they are documented as safe! One of the biggest risks of buying online is that you don’t always know where the supplements have come from.
Check that the product you buy ticks at least one of these:
- Conforms to the Pharmaceutical GMP (Good Manufacturing Practice)
- Is GVP (Good Pharmacovigilence Practices) compliant
If you’re an athlete, you’ll especially want to make sure that the product fully meets the standards set by the World Anti-Doping Agency (WADA).
Then you can look at other aspects of manufacturing that could be important to you:
- Do they use irradiated ingredients?
- Do they use ingredients certified as pesticide-free?
- What is their policy on binders and fillers?
- Are they vegetarian-friendly?
Supplements worth your money
#1 Vitamin D
Vitamin D isn’t really a vitamin at all! It’s quite difficult to get this from our diet, and those sources available just don’t give us enough for our daily recommended amount.
This is compounded if any of the following fit you:
- Dark-skinned – the darker the skin, the harder it is to get vitamin D from the sun.
- Skin coverings – if you cover most of your skin when outside, then the sun cannot penetrate the cloth to make adequate vitamin D
- Housebound – if you spend a large amount of the daytime inside the house, you’ve little exposure to sunlight
- Night workers – shift work often means sleeping during daylight hours, and therefore exposure to sunlight is limited.
It is recommended that all of the above supplement with vitamin D plus:
- Children under 5
- Vegans (however, most vitamin D supplements are not vegan-friendly). Read the post on veganism for ways to get vitamin D)
- Everyone living in the northern countries where winter daylight is restricted. Supplement between October and March.
#2 Folic Acid
Folic acid, also known as vitamin B9, occurs naturally in food as folate. Most of us can get adequate amounts from our diet if we eat green leafy vegetables, beans and whole grains.
However, there’s enough evidence that many of us don’t get what we need, and so many countries (including the UK soon) fortify flour with folic acid, so that many products such as bread will ensure people get the folic acid they need.
However, pregnant women in their first trimester and women trying for a child are particularly encouraged to supplement with folic acid even if they eat a folate-rich diet.
#3 Vitamin B12
Vitamin B12 is difficult to get if you follow a plant-based diet that has little or no dairy. Vitamin B12 is made by bacteria, and so we may make some in our gut depending upon the microbial species that live there.
But whether we absorb it, or absorb enough of it, is open to debate – but it is unlikely since bacteria live in the colon where there is little absorption taking place.
B12 deficiency is relatively common and can be tested for. It’s worth having a B12 test before considering supplements if your medical practitioner approves this.
Unless you have a medical condition that over-stores iron, some people (especially women) may benefit from supplementing with it. Iron-deficiency anaemia is common, particularly among women who have heavy periods and anyone on a plant-based diet.
Again, iron levels can be checked by looking at the blood levels of haemoglobin. So let your medical practitioner be the one to advise whether you should supplement or not before rushing out to buy a supply of them.
Whether you take fish oils or algae oil, many of us could benefit from supplement on omega-3 simply because we’re just not getting enough of it in our diets. Especially those who do not eat fish regularly.
Omega-3 is an anti-inflammatory, and helps keep a good balance in our body of pro and anti-inflammatory functions – as we need both.
However, always exercise caution when taking omega-3 with medical drugs or vitamin supplements, as you could end up consuming too much vitamin A.
Supplements that might be worth your money
Probiotics don’t work for everyone! In fact we now know that whilst the bacteria in probiotics do make it to the bowel alive, they don’t appear to stay around very long and some people even poop them out really quickly.
So taking probiotics to help recover from certain illnesses, particularly those involving antibiotics, might help. However, taking them just for general health may not actually do anything at all.
If you don’t personally feel any benefit from them, then it may be that you’re better off changing your diet so that you eat more dietary fibre, and less meat, dairy, high fat/high sugar foods.
Dietary fibre naturally feeds the resident bacteria that we already have, but for those with IBS, a high fibre diet could make matters worse.
However, no probiotic is a permanent fix! The bacteria leave your body within a few days of taking them, and so you have to stay on them to get any benefit.
#2 Digestive enzymes / Lactase
There is some evidence that people who suffer from IBS-type symptoms may benefit from using enzymes that help breakdown the sugars in their food to aid digestion.
People who suffer from bloating, gas and stomach gurgling noises and have been diagnosed with IBS could find a benefit of taking enzymes such as lactase, because their bodies lack these naturally.
Lactase helps break down the sugars in milk, and so eating dairy foods can sometimes cause diarrhoea and gas if the body lacks this enzyme.
Other sugars that ferment in the gut causing symptoms may also benefit from a range of enzyme help. You need to take these every time you eat a meal, so it can get expensive.
I’m no expert in digestive enzymes or the causes of IBS, but this blog post looks helpful; although, leaky gut syndrome is not a recognised medical condition – yet.
Who shouldn’t take supplements
Basically, anyone taking regular medication! Never take a supplement without having a discussion with your pharmacist.
Many supplements do interact with each other and with the drugs you’ve been prescribed. This is especially true of herbal medicines, but does also apply to vitamin supplements.
If you are prescribed a new medication by your doctor, try and get into the habit of having a discussion about what you should and should not take. Not just other prescribed medications that you’re on, but any regular supplement that you take that you’ve bought that’s non-prescription.
Toa Heftiba Sinca
Seb is a writer and blogger of food and nutrition. He holds a bachelors and a masters degree in nutrition science, and has studied sports and exercise nutrition at postgraduate level. He specialises in plant-based nutrition and believes passionately that we can all live with a little less meat.