The Supplement Conundrum
A woman came to see one of our nurse practitioners last week. She has a variety of complex health problems, but none of those were her primary source of stress. She was disturbed by the number of supplements she was taking. The page-long list had been recommended by an alternative practitioner at an integrative medical center. Total cost: $720 per month.
            What bothered her even more than the 21 supplements she took every day and the expense was that they weren’t really helping her. She was getting worse overall if anything.
            There is another practitioner who uses muscle testing to determine the recommended supplements for people. We have had a number of patients in common over the years and most of them end up on 10-20 supplements daily and they don’t seem to help much as far as I can tell. 
            I have had others get hair analysis through a company based in Texas. At the end of the report, they always recommend 10+ supplements to take every day. I never wanted people to pursue their regimens, but a few intrepid patients wanted to give it a go to see if it would solve their health problems. Didn’t.
            I have had a group of patients do phone or Skype consults with integrative practitioners around the country. In the majority of cases, a large group of supplements was part of the plan. In my experience, I can’t remember one time where they made a significant difference. The sample size is small, yes, but if you put those experiences with all of the others above, a pattern emerges.
            Do I believe in supplements and think they have value? Yes. Do I think they are often an important and necessary component of a plan to improve people’s health? Yes.
            It seems clear to me that over supplementation is almost never the answer. It is expensive and cumbersome. It is often a diversion from the more fundamental changes that need to be made with nutrition, gut health, mindfulness, stress management, and detoxification. 
           It can also be counterproductive because each shovelful of pills and tablets reinforces how sick the person is. Wow, I must be a train wreck with little hope of recovery if I have to take all of these damn things every day.
            For those of you who have chronic, complex health issues, I would be wary of the concept that if 5 supplements are good, then 10 must be better. I would try to work with someone who works up from the basics trying to find only those vitamins, minerals, probiotics, etc. that are the most essential for your path to recovery.
            Oh, and the record for most supplements any patient of mine was taking is 35. I work in 15 or so domains in trying to sort out complex patients and a woman came in a few months ago positive for 13 out of the 15. She was taking 35 different supplements and some were taken in more than once a today. I couldn’t help myself and tallied up the total number of non-prescription OTC pills and tablets each day: 80. I could barely convince her to stop even a few of them.

Andrew Lenhardt, MD