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Supplements A to Z

How to select the right products for you

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Supplements A to Z

What goes into the best health supplements? We check out some supplement stars, including the best supplements for women, seniors, and vegetarians.

Have you ever stood in your local health food store, looking down an aisle at row upon row of shiny supplement bottles trying to decide what—and how—to choose? It can be a little overwhelming.

Thankfully, you’ll find helpful and knowledgeable staff at most health food stores who will help you navigate through the sea of options. Nevertheless, it is useful to have some guidelines in mind to help you decide which vitamins, minerals, and/or herbal products will best suit your needs.

Here are a few tips on what to watch for, what the limits of supplements are, and which nutrients may be helpful for certain people.

Show me the evidence

Be a savvy consumer and ask questions. There is a large selection of natural health products that can help promote and maintain our health. But, as with many products and services, there can also be a lot of marketing spin.

A reputable product manufacturer should be able to provide health food stores and consumers with good information and evidence to back up product claims. Knowing this kind of information can help you decide how much truth there is behind a claim and how much benefit you can expect to derive from the product.

There are no cure-alls

If something sounds too good to be true, you know that it probably is. Products that claim to be able to treat or cure everything are being overly optimistic at best.

There is simply nothing out there that will cure everything for everybody, that will promote significant and safe weight loss without diet and exercise, or that will provide success for every single person who takes it.

Supplements are not substitutes

Supplements cannot make up for questionable dietary choices. A supplement is not going to work as well, or at all, for someone who doesn’t have a healthy nutritional foundation. Treat supplements as just that, a supplement to a healthy, active lifestyle and not as a substitute for one.

Not for serious illness

Supplements are over-the-counter products. As such, they are intended to help promote and maintain general health or relieve health complaints that are not considered to be life threatening.

Natural medicines can have a positive impact on serious illnesses, but using them in this context requires the guidance and monitoring of a health care practitioner, one with knowledge and experience in drug-supplement interactions, treating serious illness, and using natural medicines in doses that are often above what can be recommended in an over-the-
counter product.

Beware of kitchen sinks and fairy dust

One of my biggest pet peeves is the “kitchen sink” product: a product with an ingredient list a mile long that tries to include a little bit of every nutrient and herb that may help a certain population or health problem.

In these cases you will often see herbs included in amounts well below the doses that have been shown to be therapeutically useful. This practice is widely known as “fairy dusting” and it can take advantage of what consumers don’t know about effective doses of natural medicines.

Fairy dusting gives the impression there is a little “something extra” in the product, but it is doubtful the amount will have an effect. Herbs in very low doses, especially in a product with a very long ingredient list, should raise some suspicion and lead you to question whether it is therapeutic or just fairy dust.

There are, of course, exceptions to this: a few herbs are still therapeutic at even small doses, and some concentrated herbal extracts can provide benefit at comparatively low doses. If you are unsure, a naturopath or herbalist can answer your questions.

Supplement stars

A handful of supplements are widely considered to be safe for most people and can help promote and maintain general health. Here are three of the top stars in this category.

Is it truth-—or just marketing?

Question claims that seem too good to be true, and find out how much evidence there is to support them.

  • Are the claims based on human studies, animal evidence, or test tube studies?
  • How many studies have been done?
  • What were the actual results of the studies?
  • Were the studies published in a peer-reviewed journal?
  • Has the claim been reviewed and approved by the NHPD (the branch of Health Canada responsible for regulating supplements in Canada)?

Essential fatty acids (EFAs)
This term refers to omega-3 and omega-6 fatty acids. The body is unable to make these on its own and so must acquire them from the diet. Good dietary sources include vegetable oils, nuts, seeds, and fatty fish.

Essential fatty acids contribute to the health of cell membranes, the balance of hormones, and the regulation of inflammation. Conditions that have been shown to benefit from EFAs include eczema, arthritis, joint pain, menstrual pain, and some cases of asthma.

The normal development of the brain and nervous system also relies on a steady supply of EFAs, and as a result EFAs are often added to foods and supplements for children and expectant mothers.

There are many EFA supplements available on the market including those derived from seeds, nuts, algae, and fish oils—alone or in various combinations. In most cases, people require increased doses of omega-3, rather than omega-6. Your health care practitioner can give you advice about the amount of EFAs you should supplement with.

Doses range widely from 1,500 mg for general health maintenance to several grams for the treatment of inflammation.

Vitamin D
We’ve been hearing a lot recently about the importance of the sunshine vitamin. Vitamin D receptors are found on many cells in our bodies, and it turns out there is a very good reason for it: vitamin D supports the health and function of our bones, muscles, and immune system.

Researchers have shown that increased vitamin D levels are associated with decreased risk of multiple sclerosis, a variety of cancers, and even some infections. So remarkable are the potential benefits of vitamin D that the current recommended daily intake levels are under review as researchers call for an increase.

The Canadian Cancer Society has also recommended that all Canadians consider supplementing with 1,000 IU a day of vitamin D during the fall and winter in order to help decrease the risk of prostate, breast, and colorectal cancers.

I recommend 1,000 IU all year to most of my patients, because most of them spend their days working at indoor jobs, so sun exposure can be limited for the majority of the year.

Probiotics

These friendly little bacteria have also been gaining attention over the years. Although they have a long history of use in promoting and maintaining healthy digestive function, recent research also shows that probiotics may play a role in regulating our immune system.

Supplementing with some species of probiotics has been associated with reductions in illness in children who attend daycare and a reduction in childhood eczema.

For adults I generally recommend doses of 10 billion CFU per day for general health promotion and up to 400 billion CFU a day for the treatment of more serious gastrointestinal disorders.

For children, 1 to 10 billion is appropriate, depending on age and health concerns.

Know your needs

Specific populations may need more of certain nutrients.

Seniors

As we age, the risk of some illnesses increases; increasing the intake of certain nutrients may help reduce some of this risk.

Nutrient Benefit
calcium helps maintain bone density, which decreases with age
vitamin D supports muscle, bone, and immune health
vitamin B12 required for the health of nerves and blood cells; age-related atrophy of acid-producing cells in the stomach can lead to decreased B12 absorption
zinc and selenium decreased levels of these minerals is associated with increased risk of infections in seniors
CoQ10 vital to cardiovascular health and energy production; decreases with age and can also be decreased by statins, commonly prescribed cholesterol-lowering medications

Women

Certain nutrients may be needed in higher amounts at different stages of a woman’s life.

Nutrient Benefit
iron menstruating women may be at risk of iron deficiency if iron intake does not keep up with monthly losses
prenatal multivitamin associated with a decreased risk of several birth defects and some types of childhood cancers; women considering pregnancy should take this supplement and continue until breastfeeding is completed
B vitamins crucial for hormone production and regulation; some B vitamins can be depleted by birth control pills
calcium and other bone-supporting nutrients women must ensure that they build adequate bone density early on to be prepared for losses that occur during menopause

Vegetarians

Although a vegetarian diet has a long list of benefits, it does present some nutritional challenges, particularly if it is not well balanced; challenges also exist for those who are vegan.

Nutrient Benefit
vitamin B12 very difficult to acquire without animal foods; vegans need to be especially careful to ensure they are getting enough to support the health of nerve and blood cells
iron important for the health of blood cells; inadequate iron can quickly cause anemia
zinc important for a wide range of our bodies’ chemical reactions and for the health of skin, hair, and nails; zinc status can be compromised in vegetarians who are not consuming adequate nuts, seeds, beans, and/or fortified cereals
calcium vegetarians who avoid dairy products need to ensure adequate calcium to help support bone health and the function of muscles and nerves

People taking long-term medications

Many drugs deplete the levels of certain nutrients in the body, and those who are required to take these medications regularly may want to consider supplementing in order to avoid nutrient deficiencies. 

Medication Nutrient supplement
statins popular cholesterol-lowering medications; have been shown to reduce levels of CoQ10
anticonvulsants used to manage seizure disorders; can reduce levels of folic acid, calcium, vitamin K, and vitamin D
methotrexate used in the treatment of some cancers and autoimmune conditions such as rheumatoid arthritis; can lead to folic acid deficiency; supplementation with folic acid is often recommended, although it should not be combined with methotrexate during cancer treatment unless advised by a knowledgeable health care professional
metformin often used in the management of type 2 diabetes; can deplete B12 levels
acid suppressors (protein pump inhibitors, antacids) stomach acid is very important for nutrient absorption; long-term acid suppression can interfere with nutrients such as calcium, B12, iron, and zinc
birth control pills can deplete B vitamins, vitamin C, and folic acid; taking a B-complex supplement is recommended

People who are quitting smoking

Nutrient

Benefit

calcium smoking has been linked to increased risk of osteoporosis
vitamin D smoking affects vitamin D metabolism, resulting in bone loss
vitamin C smoking is thought to deplete the body’s stores of vitamin C
St. John’s wort small studies indicate this herb may help smoking cessation

When in doubt about the best supplement for your needs, always consult your health care practitioner. We hope, though, that with these tips in hand you’ll find navigating the sea of cho

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