Articles

Written by Steven Burns
From his column To Your Health

In my last column, I wrote about why you should be skeptical about supplements, especially herbal products. So, are any of them worthwhile?

First, if you eat a healthy diet that has plenty of color—lots of green and yellow vegetables, fruit, whole grains, lean meats, and not too much sugar and starch—then it is hard to avoid getting all the nutrients you need. There are no clear studies to prove supplements improve people’s health; however, multiple studies have shown that high-doses of vitamins increase the risk of cancer.

Vitamin D

Multiple studies have shown that high-doses of vitamins increase the risk of cancer.

Nowadays, we spend most of our hours indoors, at work or home. Outside, we use sunscreen to help prevent skin cancer. As we age, we absorb less vitamin D through the intestines. It has become routine to check vitamin D levels during annual physicals, and whenever I check, I find many individuals have low levels. In such cases, I may recommend vitamin D3 1000 IU daily to help. Vitamin D is necessary for the proper growth of bones. Its deficiency has been associated with heart disease and cancers, including colon, prostate, and breast.

So, before I begin, please note that taking high doses of any vitamin may be dangerous for you. Now, let’s look at some possibilities.

Probiotics

These are not vitamins, but rather bacteria that can help normalize intestinal bacterial. Normally, adults have massive quantities of these microbes. Probiotics can help to regulate the types of bacteria in the gut, reducing bad ones and increasing the good.

Omega-3 Fatty Acids

If you take more than 1000 mg (of fish oil) daily, you should be under a doctor’s care.

These oils are found in foods and, for most people, it is best to get them from a well-rounded diet. Eating fish such as salmon, cod, tuna, sardines, and shrimp two or three times a week will give low-risk individuals enough of these essential oils. For those who have a strong family history of heart disease, taking 1000 mg of fish oil daily may help reduce the risk. Beware, however, that in high doses, fish oil can cause bleeding problems. So, if you take more than 1000 mg daily, you should be under a doctor’s care.

Vitamin B12

As we age, we tend to absorb less of certain vitamins, including vitamin B12. Its absorption relies on an intrinsic factor—a substance that is made in the stomach. Without that factor, oral B12 will not be absorbed. If vitamin B12 levels are too low, a person can become anemic, and eventually nerve function can be affected. This can result in neuropathy and dementia. Vitamin B complex has plenty of B12.

Coenzyme Q10 (CoQ10)

This supplement is most commonly prescribed for patients who are taking statin drugs to lower cholesterol. Statins can reduce the quantity of CoQ10 in our bodies, and supplementing may help reduce side effects, such as muscle soreness, that can occur with these drugs. CoQ10 also may have benefit in heart disease and neurological disorders; however, deficiencies are unusual with the American diet, and taking it as a supplement is controversial.

Dietary Fiber

This fits best in a category known as “food.” The Western diet is low in fiber, which leads to intestinal problems, such as constipation and higher levels of cholesterol in the blood. Dietary fiber helps to bind bile acids from the liver and gallbladder, and keep the intestine from reabsorbing them. Since bile acids consist mostly of cholesterol, fiber helps cholesterol levels by taking it out of the body.

Okay, Doc. So, What Do I Do with this Information?

First, look at your diet. Vitamins D and B12, CoQ10, and omega-3 fatty acids are all found in fish. The best choices are salmon, mackerel, herring, trout, and shrimp. If you can’t eat fish or don’t like it (come on, now, expand your palate), you can get all of these (except for omega-3 fatty acids) from eggs, dairy, and beef.

There is a dizzying array of probiotics in every pharmacy—or you can eat yogurt. Most yogurt forms contain active cultures, and will give much of the benefit of probiotics.

Fiber is found in most vegetables and whole grains. Some studies recommend as much as 30 grams of fiber per day, but that quantity can cause intestinal cramping and diarrhea, so 20 to 25 grams may be a better goal. If you can’t get this amount in your diet, fiber supplements (psyllium, methylcellulose) can help to reach the goal.

The bottom line is that if you eat a healthy diet, you probably don’t need any supplements. Who knew?

Dr. Steven C. Burns is board-certified in family medicine and has been in practice for almost 30 years.

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