To take or not to take supplements?

That is one of question in health tabloids a la mode these days.  And as always, it is not that simple. Nothing is obvious when it comes to general health, except for that too much and too little is always bad.  But that is true about everything, anyway.

               We ridicule people who present claims and statements that are not backed by scientific evidence. But behind that scientific evidence the evidence is frequently really weak.  Some medicines that are recommended for common diseases like osteoporosis and high cholesterol require a large amount of people to be treated to benefit only one or two, like 1 person out of 100 benefits from using treatment for osteoporosis or 1 out of 30-40 for preventing heart disease.  That one person is the lucky one but the others just get the side effects or take a pill for no good reason.  The reason for this is that we don’t exactly know, who will benefit,  and we treat them all with all of our good intentions.

               Same is for supplements. The science is weak and frequently flip-flops, making not only public but, also, doctors crazy.  Beta-carotene, vitamins E, folic acid, niacin were good for you five years ago, but now, “no more”. Just last week I recommended to the patient to take magnesium, she got home and called me right back after she saw that magnesium might cause I can't remember what, to which I recommended to her not to go with my recommendation. Internet is the greatest source of confusion.  I tried to look up what was wrong with magnesium and still couldn't find but I'm sure something was there.  Another "doesn't make any sense" example that I see pretty much every day is that the sickest middle age people I have in my practice eat only organic foods and take all the "recommended" supplements. I'm pretty sure that there is no correlation between the two, but the obvious message is - the supplements and organic foods do not bring their health back.

               There are three major factors that impact our health:  genetics, age and environment. Until we know our genetics, and as long as we remember our age, we have impact only on our environment.   But when the equation has three variables: one somewhat unknown, the other one relatively stable but impossible to change, we can full around only with our eating, drinking, activities and exercise. What about supplements?  Eat healthy, exercise and take vitamin D, not too much and not too little: 1000 u of D3 will do it for most people.