I classify supplement information into 3 categories.

Category 1
Loose Theory.

In theory, taking a collagen supplement should put collagen into your body, which should find it’s way to your skin, and improve it. Sounds OK. We know a lot about nutrient metabolism, but sometimes we ignore it if there’s money to be made. We have research that shows 60mg zinc/day can shorten the length of a cold, so in theory, lower doses of zinc could still be beneficial…? Sell it! Better yet, sell it in a gummy form!!

Category 2
Experience Based.

In reality, there are a billion additional variables when it comes to taking a dietary supplement and getting it absorbed and utilized in the body without anything else getting in the way or being adversely effected. When a practitioner observes hundreds of patients over the years and their response to various supplements, a new kind of information is learned. Some forms of magnesium are better than others. People who are not deficient in B12 don’t feel better after taking it as a supplement. No one enjoys taking L-glutamine powder. This is valuable stuff! But often discredited because it’s not consistently validated by research studies. 

Category 3
Evidence Based.

This is what the ODS focuses on. It’s great stuff! No one wants to do harm when they recommend supplements to their patients, or friends, or family members. If you can find good research on supplements, that’s awesome. Sadly, it’s a poorly researched field. Sometimes the best information we have is based on someone else’s experience. So you do your best to determine how trustworthy that person is, and weigh the risks and benefits. 

Vitamin D
(cholecalciferol is D3, and ergocalciferol is D2)

Sources:
mushrooms, some oily fish, dairy products (from fortification), sun exposure.

Function:
strengthen bones, muscle contractions, nerve conduction, decrease inflammation by controlling overactive immune responses and increasing resistance to infections

Location:
stored in fat, transported through blood to liver and and kidneys

Research:
so very mixed. We know it’s bad to have low levels, but the research that shows benefits from taking a supplement isn’t “solid” in everyone’s opinion. It’s possible that the low vitamin D levels we see in blood tests is only a side effect of another problem. Fixing side effects does not resolve the problem, but we also don’t see any risks to supplementing with 1000-2000IU Vit D, and some folks truly feel better doing this.

Who should be concerned?
Most of our Vit D is absorbed through our skin, and skin color can make a big difference in our rates of absorption. Research shows higher rates of deficiency in populations with darker skin. Age changes our skin too making it more difficult to get the Vit D we need from minimal sun exposure. Body composition also matters. Vit D is stored in fat, and research shows that people with more fat mass require more Vit D in order to prevent deficiency. And finally, because of it’s relationship with the immune system, it’s often recommended for folks with auto-immune conditions to take a Vit D supplement.

Supplements
Vit D3 (cholecalciferol) is slightly better absorbed, but Vit D2 (ergocalciferol) is adequate for vegans who are concerned with D3’s animal nature.

Omega 3’s

Sources:
Alpha-linoleic acid (ALA) found in walnuts, canola oil, flax, chia, hemp seeds, and some cruciferous veggies such as kale and brussel sprouts
EPA and DHA are the omega 3’s we get primarily from fish and seaweed (fish oil from small fish like sardines, anchovies, and mackerel is the best/cleanest source)
Function:
Regulates immune and inflammatory responses, promotes wound healing and healthy skin and hair, regulates metabolism, and supports the structure and function of our brain - particularly during fetal and early childhood development
Who should be concerned?
Anyone not eating 2-3 servings of omega rich fish per week, pregnant women, folks with high triglycerides, autoimmune diseases, or head trauma/brain injury.
Supplements: Most omega 3 supplements are fish oil supplements containing EPA and DHA. Supplements sourced from small fish means less mercury and other toxins like PCB’s. EPA is tied with heart health and DHA tied more with brain health. For most people just trying to make up for not eating fish, the low doses sold at drug stores are fine. You’ll want a higher dose of EPA to bring down triglycerides, and a higher dose of DHA if you’re looking for potential healing after a brain injury.

CoQ10 (ubiquinone)

Sources: fish, organ meats, whole grains, dark leafy greens. Exposure to sun helps us properly utilize CoQ10.
Function: proper performance of mitochondria, helps zinc enter cells for immune benefits
Location: concentrated in the heart, liver and pancreas
Research: used in combination with heart meds to improve outcomes in those with heart disease. Can lower blood pressure. Prevents migraines at 100mg TID. Currently being researched as a deterrent for periodontal disease.
Drug interactions/depletions: Statins lower our own CoQ10, so can beta blockers and tricyclic antidepressants. 
Health conditions: those with Parkinsons and dementia see benefits of supplementing with CoQ10
Supplement: not always bioavailable. Look for ubiquinol. Consume supplement with fat and take lower doses throughout the day rather than a high dose one time.

Probiotics

Sources: various strains of yeast and bacteria found in fermented foods such as yogurt, kombucha, kefir, saurkraut (not if made with vinegar) and kimche
Function: Having the right bacteria in our guts leads to optimal digestion and absorption of nutrients. The right balance of good bacteria can fight against the inevitable bad bacteria we’re exposed to.
Location: research is primarily focusing on gut bacteria, but beneficial bacteria lives all over your body - inside and out!
Research: The recommendations behind probiotics are changing and it’s exciting. For a long time everyone practice under the knowledge that “there’s potential… and it’s not harmful… so why not try?” But now researchers are closer to figuring out strain specific recommendations. Many practitioners are holding back on making recommendations outside of when someone is taking an antibiotic, prevention of C-Diff, or low birth-weight infants, until we’re prepared to make more accurate recommendations. There’s so much potential here!

Iron

Sources: meat, beans, shellfish, nuts, dried fruits and fortified cereals as well as some plant sources like spinach though these aren’t as well absorbed.
Function: iron bound to hemoglobin (red blood cells) carries oxygen throughout the body. Iron is needed to make DNA too - crucial for fetal and infant development.
Location: circulates in the blood and excess is stored in our organs such as pancreas and liver
Who should be concerned: Folks exposed to lead (that’s us here in Chicago) should make sure they’re iron levels are adequate. Pregnant women, infants, children. Athletes.
Supplements: A lot of people need an iron supplement, but a lot of people take it incorrectly. The wrong form of iron can cause constipation, creating another problem. This happens often in infants consuming iron fortified cereals. Taking calcium with your iron may block absorption. Taking it without Vit C will decrease your absorption. Because you don’t pee out the excess, you should have your blood levels checked regularly if you’re taking an iron supplement long term.

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