By Dr Astrid Boeckelmann, naturopathic physician

Up to half of the adult population in the United States takes supplements on a daily basis; and the Americans are not alone, similar figures are reported in other countries. So, just what is the appeal? How cost- and, more importantly, health-effective are over-the-counter supplement preparations? Can they really do all that they promise? Are we actually doing ourselves more harm than good?

The appeal of supplements

Everywhere we turn these days, it seems that we are bombarded with advertisements telling us to take this vitamin, or that supplement; promising everything from stronger bones, to healthier hair. Even before we are conceived our mothers are encouraged to take supplements, and this subliminal marketing continues throughout childhood, adolescence, the menopause. In fact, at every life stage you can think of there is a recommended supplement, guaranteed to make a difference for the better.

But will it?

Firstly, let’s consider the reasons for taking a regular supplement. Is it to make up for a deficiency in a particular vitamin or mineral; or is it more of an insurance policy – a just-in-case, let’s-cover-all-bases approach? With the former, there is a sound medical basis for taking supplements and the resulting impact will likely be positive. With the latter, there is a real need to explore the possible impact on your health, not to mention your wallet, and consider whether an over-the-counter concoction is really the best approach.

Health risks and efficacy of supplements

Fundamentally there is very little scientific evidence that over-the-counter supplements offer any actual health benefits. But, so what? If this is true, then surely the worst case scenario is that you are wasting your money? Unfortunately this is not the case, some supplements have been shown to be detrimental to health and exceeding the recommended daily dose can cause a potentially dangerous build-up of levels in the body. For example:

  • High doses of vitamin C (exceeding one gram) taken orally can cause nausea, diarrhea and stomach cramps. In order to achieve the anti-cancer effects of high-dose vitamin C, you need to take it intravenously (20g instead of the typical 0.5g taken by mouth.)
  • Beta carotene (a precursor of vitamin A) has been linked to an increased risk of lung cancer in high risk individuals (smokers and asbestos workers).
  • Vitamin A itself has a worrying association with osteoporosis, increasing the risk of hip fracture. It can also cause birth defects if taken at a high dose by pregnant women.
  • Calcium and vitamin D are frequently taken together. It is difficult to overdose on vitamin D, however too much calcium can cause kidney stones.

There are also certain guidelines to be followed to ensure that the supplement is formulated in a way that ensures efficacy. For example, when taking probiotics for gut health and emotional wellbeing, you need to ensure three conditions are met. Firstly, the potency – it should contain at least 20 million colony-forming units (CFUs), secondly there should be multiple strains of probiotics and, thirdly, they should be bio-available, meaning they are easily absorbed by our bodies.

The issue of regulation

Perhaps one of the biggest issues with supplements is that they are not regulated by the American Food and Drug Administration (FDA) in the same way as prescription drugs are, meaning they have not had the same rigorous safety testing. Manufacturers of over-the-counter supplements are not obliged to reveal any problems with their products. In addition, the labels on commercially available supplements can be misleading; sometimes key ingredients are only present in minute quantities, due to high cost; other times preservation compounds are added to prolong the shelf-life of the supplement, but these inhibit the performance of the key ingredients. Perhaps even more worryingly, one recent study found that 60% of supplements tested contained ingredients not listed on the label, some of which were harmful contaminants.

In addition, the amounts listed on a product label could be false in the case of some manufacturers, as can be witnessed from past law suits in the US.

The excessive heat and high humidity that characterizes the climate of the UAE can also affect the activity of supplements. Take, for example, those supplements that promise to improve your digestive health through the action of ‘good bacteria’. Initial bacteria counts are taken at time of production; however, these levels can reduce significantly over time, particularly with environmental exposure. Two of the worst environment offenders? You guessed it, heat and humidity.

When supplements are beneficial

This is certainly not to say that supplements are all bad, nor that they are ineffective, or should never be used. Supplementary vitamin B-12 is useful for elderly people, who are less efficient at absorbing dietary B-12. Glucosamine has been shown to provide some benefit to patients with osteoarthiritis, and a formulation including vitamins C, E, carotenoids, zinc and copper appears to slow the progression of age-related macular degeneration.

Experts agree that the majority of us will be deficient in vitamin D and omega-3 fatty acids. In fact, it is estimated that 90% UAE residents are vitamin D deficient. Long term deficiencies in vitamin D can cause multiple sclerosis and an increased risk of diabetes I and II. Supplementing vitamin D levels, will reduce these risks and can also help protect against osteoporosis. Additional omega-3 fatty acids can be cardio-protective.

Maximizing the health benefits of supplements

The truth is that there is no ‘one size fits all’ approach to taking supplements. We all have differing needs, deficiencies and genetic predispositions. A supplement concoction that works for one person, may not work for you. The optimum solution is to undergo blood testing at an integrative medical facility, such as Novomed, and work with a specialist to design a highly personalized treatment plan that works for you, maximizing the health benefits and minimizing the risks.

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