The 30-billion dollar a year vitamin industry is suffering from existential angst right now. Their collective stomachs are all aflutter because of the publication of a new study in the Annals of Internal Medicine that says vitamin or mineral supplements offer no discernible benefits; that they don't reduce the risk of death from practically anything and they might, in fact, harm people. (1)
Now all those supplement companies are wondering if they should instead start selling roofing materials or something else useful.
I've got no solace to give. Unfortunately for the vitamin seller, yeah, most vitamins and mineral supplements are a waste of time. Some could actually harm you. And yeah, you're often better off getting some vitamins, minerals, and other classes of supplements from whole foods.
But there are notable exceptions. In those cases, it's unrealistic or even plain daffy to rely on whole foods to fulfill all your supplement needs. Let's take a look at some of the most common vitamins, minerals, and supplements and see if we can make some sense of it.
I don't think there's a single reputable study that shows they're effective, but we don't need studies to come to this conclusion. There are just too many problems with multivitamins:
The one-size-fits-all philosophy.
The human need for the 24 vitamins identified by science is based on a bell curve and while it may hold true for a 150-pound municipal worker named Phil who lives in Akron, Ohio, they might not hold true for sweaty athletes, bigger (or smaller) people, or you.
Giving the same vitamin combo to every man or woman alive is like making only one size of underwear for everybody – fine for some, but uncomfortable, unworkable, and in the case of vitamin-caused skin reactions, even unsightly for others.
So many possible interactions.
Vitamins A, D, E, and K are fat-soluble and, as such, are best taken with food. Iron shouldn't be ingested with coffee or tea because the tannins in them interfere with absorption. Likewise, iron blocks the absorption of zinc and copper. Vitamins E and A can gang up on K.
Cherry picking and not seeing the big picture.
Maybe, just maybe, these nutrients aren't supposed to be isolated and taken by themselves. Maybe they need to be taken in whole-food form to be truly effective. Maybe the nutrients need to work in conjunction with some (or maybe even all) of the micronutrients and phytochemicals intrinsic to the whole food source for them to work.
Taking too much calcium (more than about 1,000 mg. a day) can be a huge problem. At worst, the calcium starts to accumulate on the linings of your heart and arteries so that they look like the tiled walls of a White Castle restaurant. The excess calcium might also form kidney stones or, on the less severe end of the spectrum, cause constipation.
Calcium is one example where people really would be better off getting this crucial mineral from whole food. Here's the thing: When you get too much calcium from foods (milk-based protein powders, dairy products), a fail-safe system kicks in and the intestines start limiting further absorption of the mineral.
Not so with calcium supplements. They have no fail-safe system. The more you take, the more ends up in your urine, blood, kidneys, heart, and arteries.
The study from the Annals of Internal Medicine found that when people who weren't deficient in vitamin D took vitamin D supplements, they had higher risks of death from all causes, particularly cancer.
It's important to realize that this study was based on people accurately remembering and reporting what they had eaten over a period of several years, so it's easy to be skeptical, particularly when several other studies have shown that people who took vitamin D supplements lived longer, on average, than those that didn't take it.
Sure, ideally, we'd all lie naked in the sun like harp seals for at least 20 minutes a day so we could make our own vitamin D, but that just isn't plausible for everybody, particularly if you live anywhere north of Memphis, Tennessee (about 2500 miles north of the equator) or, for that matter, anywhere south of Santiago, Chile. (2)
The sun just doesn't get high enough during winter months in those areas for all those vitamin-D generating UVB wavelengths to benefit us. Never mind persistent clouds.
The Chippewa tribe of Michigan had an old saying: "If the shadow of a groundhog is longer than it is tall, its body isn't making vitamin D." Alright, the Chippewa didn't say that, but if you apply the "longer than tall shadow" thing to yourself, the advice pretty much rings true.
If you can't regularly spend a few minutes in the sun, or you're a mole-like gym person who rarely see any lights that aren't fluorescent, you should probably take vitamin D year-round.
If you're over 40 or 50, or if you've got cholesterol issues, think about taking niacin. While its rep as a supp that lowers cholesterol has taken hits over the last few years, a new study showed that it did as well as statins in keeping cholesterol levels down but without any of the side effects. (3)
Niacin may also be one of the two known things (the other being a $14,000 a year drug) that can combat something called lipoprotein(a), an almost ignored lipoprotein that hardly any doctors test for and is thought to triple the risks of having a heart attack at an early age.
This vitamin was the first antioxidant that achieved superstar status and people started taking obscene amounts of it to ward off disease and to speed up recovery from colds and flu. Unfortunately, studies haven't found it to do any of that.
Worse, even though vitamin C is an antioxidant, it turns into a "pro-oxidant" when you take large amounts. That means overuse could actually make it churn out free radicals instead of mopping them up.
Obviously, having a deficiency of vitamin C could hamstring your immune system, but you should be able to get all you need through citrus fruits.
A few studies came out in the '80s and '90s about how vitamin E might prevent cancer, so the tiny yellow gel caps became a mainstay in medicine cabinets everywhere.
But then, in 2011, a really big study of close to 36,000 men came out that said the opposite: Vitamin E increased the risk of prostate cancer. Given that it's pretty easy to get enough through your diet, you've no real reason to go the supplement route.
Oddly enough, goose meat is probably the dietary source with the highest concentration of vitamin E, but if you've had your fill of goose meat, you can get plenty of the vitamin by eating nuts, seeds, leafy vegetables, avocadoes, and various fishes.
Up to 85% of Americans might be deficient in magnesium. It's probably even worse in athletes because sweating like a farm animal causes it to leech out of the body.
This is a big deal because the mineral plays a role in over 300 biochemical reactions in the human body. Among other things, magnesium is crucial to energy production, protein synthesis, and insulin metabolism. Without enough of it, you get undue lactic acid build-up, muscle cramping, poor recovery, and poor exercise performance in general. A deficiency also makes it harder to lose fat.
Taking a supplement like ZMA® should remedy all those symptoms and side effects, and one study says that when you combine it with intense exercise, it can increase testosterone levels by a stratospheric 25%. (4)
Zinc deficiency used to be pretty common, but it's starting to show up in all kind of products that weren't meant to be nutritive, like toothpaste and eye drops. As such, deficiencies aren't as common as they used to be.
Regardless, zinc has a couple of attributes that make it conditionally essential. For one thing, if zinc levels are low, as they often are in athletes, it can lead to low testosterone levels. Furthermore, zinc is one of the few things that's been shown in decent studies to shorten the duration and severity of colds.
So take zinc supplementation – or a mineral formula containing zinc like ElitePro™ Minerals – daily, or at least when you feel a cold coming on.
The concept of antioxidants is spot on. Any one of a number of factors, including UV radiation, toxins, heat, cold, infections, or pollutants can damage cellular DNA or compel it to commit suicide, but antioxidants can stop both the damage and the suicide.
But there are problems with dumping huge amounts of vitamin C, E, N-acetylcysteine, or whatever else is the popular antioxidant of the moment, into your body.
For one thing, it might be the wrong dosage, the wrong timing, or even the wrong antioxidant. Moreover, this type of antioxidant cherry picking can completely turn off free radical leakage in the mitochondria (which is what antioxidants target), which leads to the cell committing suicide and that's exactly what we were trying to prevent in the first place by taking antioxidants!
So in the case of controlling free radicals, it seems you're damned if you do and damned if you don't.
The best strategy is to eat a variety of fruits and vegetables so that you're getting a realistic dosage of a combination of antioxidants – not a buttload of a particular one.
Alternately, use a product that's made of a combination of a variety of fruits and vegetables, like Superfood, that approximates what you could get by eating the oft-prescribed 10 servings of fruits and vegetables a day.
Probiotics are a great idea... in theory. Feed your gut wee little beasties and they go to work for you like so many cilia-covered indentured servants, but there are so many reasons why they probably don't work.
For one, everyone's gut biome is probably as individual as fingerprints, and making blanket recommendations (as you do when you take a specific probiotic supplement) as to what microbes should be introduced to your gut is probably futile.
Even so, you can inundate your gut for weeks with a particular species or several species and they just plain fail to take hold and populate.
It's also hard to know if your expensive probiotic is viable or not. These things generally need to be chilled so that all microbial metabolism stalls. That means that it's imperative that the temperature chain of command doesn't get broken by some Doug Heffernan delivery man leaving the box of pills on a hot stoop somewhere.
The bacteria wake up when exposed to heat and start to look for things to metabolize. Given that there's no food for them in the capsule, they go Donner party, subsisting on each other's corpses until they too die.
Anyhow, for whatever the reason, the studies on these things show widely divergent results. If you believe in the concept regardless, stick with things like yogurt and other fermented foods, which are a lot cheaper in the long run.
The best strategy of all, though, might be in eating prebiotic foods; things like sauerkraut and kimchi and kombucha tea that not only introduce hopefully beneficial bacteria to your gastrointestinal tract, but also feed them at the same time.
Several recent studies have cast a big Meg-sized shadow on the efficacy of fish oils in warding off heart disease. Their findings were kind of predicable, though. For one thing, they often used anemic dosages in their studies – it takes more oil to fix heart disease than what you can get by squeezing a single mackerel.
More importantly, these studies often don't require the participants to make any dietary changes other than adding fish oil to their diets. Fatty acids are competitive bastards; they all want to chomp onto the same cell receptors but if the cell receptor is already occupied by another fatty acid, fish oil can't attach and do its job.
Lastly, no one has disputed that fish oils are powerful anti-inflammatories. So, if heart disease is, as most cardiologists agree, a disease of inflammation, it only makes sense that a good fish oil supplement (DHA / EPA re-esterified triglycerides) like Flameout® would be a good thing to take.
Getting most of your nutrients through whole food is undeniably smart. But the study from the Annals of Internal Medicine cast a dim light on all supplements; the paper got people thinking that maybe they could go to "natural" sources for all their supplement needs.
Okay, but consider this analogy: Aspirin comes from tree bark, but don't tell us we need to eat an elm tree to cure a headache when we could just take a couple of aspirin tablets.
Similarly, you could eat all the turmeric in an Indian restaurant but you're still not going to absorb enough of its active ingredient, curcumin, to have any measurable health effects. Instead, we take curcumin capsules.
The same is true for a whole spectrum of supplements. Plus, there are times, because of modern living conditions, that our bodies are going to be in short supply of things we need or things that could help improve some aspect of health, and whole foods aren't always going to provide the physiological doses we need.
- Chan F et al. Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults: A Cohort Study. Ann Intern Med. 2019 May 7;170(9):604-613.
- Cabotaje A. Are Vitamins and Supplements a Waste of Money? Well Health, January 21, 2019.
- Superko HR. Niacin and heart disease prevention: Engraving its tombstone is a mistake. Journal of Clinical Lipidology. 2017;11:1309–1317
- Cinar V et al. Effects of magnesium supplementation on testosterone levels of athletes and sedentary subjects at rest and after exhaustion. Biol Trace Elem Res. 2011 Apr;140(1):18-23.