This article is shared with permission from our friends at dralisonchen.com.
Wander a health food store and you’ll be overwhelmed with rows and rows of different supplements: vitamins, minerals, protein powders, fiber, herbs, homeopathic, and combination formulas in various bottles of liquid, pills, and capsules.
You can find many of the same vitamins and supplements in different forms with a wide range of prices. Let’s take magnesium for example:
While most people will choose a nice looking product in the middle price range, due to human behavioral psychology (read Predictably Irrational on this fascinating topic), very few people know exactly what are the best supplements for them.
Did you know that magnesium bisglycinate isn’t the same as magnesium malate?
Prescribing nutraceuticals, botanical herbs, and homeopathic is a science and art. That’s why Naturopathic doctors complete a 4-year accredited doctorate degree, including a year of primary internship and are regulated with 2 National board examinations before they can practice.
What to Know About Vitamins and Supplements
Vitamins come in ‘active’ and ‘inactive’ forms. Depending on your current physical capacity and purpose for taking the vitamin, one form may be more appropriate than the other.
In general, ‘active’ vitamins are readily absorbed and used in the body, while ‘inactive’ forms require several chemical reactions before being utilized in the body. If your body is unable to convert the ‘inactive’ into ‘active’ form or appropriately absorb the supplement, you’ll be throwing money down the drain until you treat the root cause.
For example, lack of intrinsic factor doesn’t allow vitamin B12 to be absorbed through the stomach lining no matter how much B12 is available in the stomach.
Along that note, B12 is best absorbed sublingually (under the tongue) or via injection into the muscle, and there are 3 main forms of B12:
- Cyanocobalamin is synthetic form of B12, which is cheap and most often prescribed by MDs
- Hydroxycobalamin is a common form used for people with B12 deficiency anemia
- Methylcobalamin can cross the blood-brain-barrier and most appropriate for neurological complaints
Minerals are interesting supplements because they require molecules to bind to them in order to be absorbed effectively by the body. These molecules are called “carrier molecules” and they significantly impact the functionality of the mineral on the body.
If we look at our previous example of Magnesium (Mg), these are some common forms and a very basic guide for use:
- Mg (bis-) glycinate for muscle aches
- Mg citrate for constipation and insomnia
- Mg taurate for low energy or restless leg type discomfort
- Mg malate for fibromyalgia-type pains and fatigue
- Mg-oxalate for constipation but can cause stomach pains
- Mg sulfate is Epsom salt for bathing sore muscles
Also, some minerals are best absorbed when taken along with other supplements, such as iron and vitamin C.
Botanical herbs are the most important supplement to have prescribed appropriately and of high quality. Herbs have the potential to be as effective but also as dangerous as pharmaceuticals.
The active constituents of an herb can be the bark, root, stem and/or leaves and extracted by water or alcohol. Depending on the condition of interest, a Naturopathic doctor will recommend various forms of supplementation: tea infusions, liquid distillations, or concentrated powders with or without meals at divided intervals.
For those who use homeopathic, potency is important. Arnica at 6C is not the same as 1LM. The following is a general guide to dosing homeopathic:
- Low potency (ie. C or CH= 100 x) at more regular intervals for physical or acute complaints.
- Medium potency (ie. M = 1,000,000 x) once or for 3 consecutive days with emotional and constitutional remedies.
- High potency (ie. LM +>100,000,000 x) once for deep seeded emotional and constitutional pictures. Not to be self-prescribed, especially with psychological conditions.
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You should also take into consideration the form in which your supplement is in and how it will best benefit your health:
- Lozenges – Dissolve in the mouth and has a local benefit as well as vascular (blood stream).
- Sublinguals – Dissolve under the tongue to be absorbed more directly into the blood system.
- Liquid Form – It can be based in water or alcohol depending on the availability of the nutriceutical or herb. The liquid is generally better absorbed with fewer fillers but have less accuracy in measuring the dosages.
- Capsules – These are the most accurate way to take in the correct dose of a supplement and it can bypass any bad taste. Be cautious of added fillers and potentially allergenic ingredients.
- Tablets – These are compact supplements that break down and absorb in the digestive tract. They can also contain fillers, but you avoid ingesting the gelatin capsule.
- Intramuscular Injections (IM) – These are supplements injected into the belly of a muscle, such as vitamin B12.
- Intravenous Injections (IV) – These are direct injections into the blood stream, such as vitamin C.
Based on the above information, you can see the intricacies with prescribing supplements. In general, I do not recommend self-prescribing unless a licensed Naturopathic doctor has already given you the prescription from a previous appointment. Even still, quarterly visits with your physician are beneficial for sustaining optimal health. To learn more about Naturopathic medicine and where to find a local ND, click HERE.
If you do choose to self-prescribe for basic concerns, please keep these top precautions in mind when choosing supplements for your health:
Top 8 Self-Prescribing Mistakes
1. Choosing Products Based on Price
More expensive doesn’t mean better. It’s true, most professional brands do cost more, but that shouldn’t be the basis of your supplement choice.
Professional supplement brands generally cost more because they are reliable. Due to their rigorous standards, they ensure high quality, potency, and purity along with 3rd party testing and research. The main North American professional brands that follow such stringent quality assurance include:
- Seroyal (Genestra)
- St. Francis Herb Farm
- A. Vogel
- Thorne Research
- Restorative Formulation
- Douglas Labs
- Pure Encapsulation
- BioClinic Naturals
- Integra Nutrition
- Integrative Therapeutics
- Orange Naturals
- Natural Factor
- Progressive Nutrition
However, just because the company holds high standards, doesn’t mean that a professional supplement will be most appropriate or effective for you. Naturopathic doctors take the time to look at the source of your concerns so that you are prescribed treatments, vitamins and supplements that support the root and not just your superficial symptoms.
Also be cautious of products on “SALE”. Most often these are overstocked supplements that may be close to expiry. Even though many supplements are still safe to consume up to 6 months past their expiry date, the efficacy of the active ingredients may not offer you a wise trade off. Never purchase unstable oils that are spoiled (ie. fish, flax seed or avocado oil).
2. Asking Health Store Workers for Recommendations
This is not a jab at health store employees, I was one. I worked at Qi Natural Foods in Toronto for 2 years and learned so much. Not only did I get trained on different supplement products but I was able to understand the kinds of questions and concerns customers were coming into the store with.
Despite the training received during my time at Qi, the education was not complete. All of the training was given by supplement companies and therefore was lacking basic science background and had a lot of bias. There are no minimum education levels for health store workers, so don’t expect to get the same quality of information as a licensed Naturopathic doctor, nutritionist, dietician, or Medical doctor.
3. Using Dr. Oz or Similar Shows or Magazines to Self-Prescribe
Working at the health food store also gave me insight to the source of most customers questions. I can’t tell you how many times someone came in saying, “I heard on Dr. Oz that XX was good for losing weight.”
Every week the XX supplement would be replaced with the next best thing: Green coffee bean, raspberry ketones, CLA, super greens, Garcinia cambogia, chlorophyll, etc. And they would also be the first things needed to be re-stocked.
I have nothing against Dr. Oz himself. I think he has done a great job bringing preventative medicine into the spotlight, despite some questionable affiliations to companies and products. However, the responsibilities lay with the audience to realize that his recommendation are general and sometimes not backed up with research.
Stop using TV and magazines as your prescription pad. Even if they are reputable sources, do your due diligence to take what they have to say with a grain of salt. Read the evidence-based information and bring your questions to your Naturopathic doctor.
A great source of information and high-quality research is Natural Health Products Assist (NHP Assist). It is founded by Naturopathic doctor Matthew Gowan, who has been the nutrition and botanical professor as well as clinical supervisor for the Canadian College of Naturopathic Medicine (CCNM) with over 10 years of clinical and research experience.
4. Using the Directions on the Bottle for Recommended Dosages
If you are using the directions on the bottle and not the prescriptions of a Naturopathic doctor, you may be wasting your money. Recommended dose is not the same as a therapeutic dose.
Many supplements have to write a dose range within the safety guidelines of the FDA. Of course, this is smart for companies to follow. However, if you are not taking a high enough dose for a specific amount of time while tracking your symptoms, you may not get the effect you’d be hoping for. This level of supplementation that is based on research studies and clinic experience is called the therapeutic dose.
For example, most research done on vitamin C uses 2g per day as the therapeutic dose to support the immune system and decrease inflammation. However most multi-vitamins and even vitamin C supplements contain less than 100mg, which is nowhere near levels to support therapeutic effects.
5. Not Reading Labels
Labels can be deceiving and confusing. Not only should you be aware of the active ingredients in a supplement, but also the non-medicinal ingredients. Fillers and bulking agents are often added to supplements and provide no medicinal qualities and could be a source of sensitivity or allergy.
Non-medicinal ingredients to be aware of include:
- Potential Allergens: dairy, gluten, soy
- Gelatin if you are a vegetarian or vegan
- Hydrogenated oils
- Magnesium stearate
- Artificial coloring
- Titanium dioxide
Also keep in mind dosage and serving sizes when comparing different products.
6. Thinking All “Natural Remedies” Are Safe
Natural does not mean safe. Remember when I spoke about botanical herbs having the potential to be as harmful as pharmaceuticals?
There are also many conditions and drugs that are contraindicated or not allowed to be taken together with certain supplements, for example:
- Fish oils are contra-indicated with Warfarin
- Vitamin C is contra-indicated with psoriasis
- Licorice (Glycrrhiza glabra) is contra-indicated with hypertension
- Iron with bacterial infection
- even grapefruit with many medications is contra-indicated
If you are taking any medications, it is crucial that you have your Naturopathic or Medical doctor cross-reference the pharmaceuticals with supplements, especially botanical herbs, to look for any drug interactions.
Bringing a treatment reference sheet to every medical appointment will be helpful for all practitioners to work together and maintain your safety. Click here for my free Treatment Protocol worksheet and sign-up for the Daily Dose Calendar today.
7. Not Tracking Your Progress or Having a Re-Evaluation Date
You should always know what you are taking a supplement for and for how long. Track your symptoms to ensure you are getting the appropriate benefit from a supplement and not wasting your money or worse yet, getting a negative side effect.
A general guideline is 3 month to re-evaluate your protocol with your Naturopathic doctor. Many supplements are most effective when taken for a short period of time at the therapeutic dose. Some supplements can actually be detrimental to your health, such as vitamin B6 and zinc when taken long-term without appropriate testing or follow-up exams.
Print off my free Symptom Tracker worksheet to take control of your health.
8. Relying on Supplements Instead of Food
Supplements are just that, a supplement to what you are already doing. Don’t think that just because you are taking a one-a-day multivitamin that you don’t need to eat a well-balanced meal.
I love having a super greens protein shake first thing in the morning to ensure that I’m getting all of my essential nutrients, as well as protein, fiber, and water.
As we get busier, often times our diets become less varied, and we start to eat the same 10-15 foods every day. It is possible to become nutrient deficient even if you are eating healthy meals. Supplementing with a fortified shake or bar can be very beneficial to your health, but remember to always eat your veggies. If you do choose to use supplements, make sure you are using the best supplements and the best vitamins for your needs.
1. Chen, A. (February 22). Top 8 Self-Prescribing Mistakes You Must Avoid. Retrieved August 31, 2016 from http://www.dralisonchen.com/2015/02/top-8-self-prescribing-mistakes-you-must-avoid/
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