Dr. Paul Andersen answers questions about dietary supplements, explaining that food comes first but deficiencies or high activity may require them. Supplements skip the clinical trials required for drugs and carry risks like heavy-metal contamination and counterfeits. Look for manufacturers with Good Manufacturing Practices and batch testing data, like Seeking Health or Pure Encapsulations.
Chapters
Good day and welcome to Medicine Health with Dr. Paul Andersen. That's me, I'm Dr. Paul, and this is a version of the podcast, Dr. A on the Road. So I have a different camera setup. I I actually am not quite the color that you see there, but the camera is doing some interesting things today, so we're just going to live with it. Today we've got 4 Q&As. In the first Q&A, I wanted to talk about was some specific questions that I got with regard to supplements, dietary supplements specifically. And what about them? you know, some specifics about their safety, etc. So a couple of things. The first thing is, obviously, as I always say here on the program, your diet should always be the first place where your nutrients come from. It should ideally be the major place where your nutrients come from. Now, sometimes that's not possible, and we understand that. And sometimes there are specific deficiencies that a person may have. And sometimes there's even genetic reasons for deficiencies. So supplementing your diet with nutrients comes in all manner of forms. So that could be basic things like vitamins or minerals, could be amino acids, it could be certain types of fats. You probably have seen people take omega-3 or fish oil or something, or phospholipids, phosphatidylcholine, or some of the other phosphatidyl groups. And so All of these things can be supplements, and as I said, they normally come along with your diet. Now, when do you need them? Why do you need them? Well, there's a lot back and forth in the world of nutrition science around supplementation. And so you can kind of, in some ways, depending on what research you look at, you can kind of get whatever advice you would like to find. Most people feel that in modern times with modern agriculture and a lot of the nutrient deficiencies that are engendered by modern agriculture, we would do better to have a level of exogenous or outside supplementation that we are using to support what our diet is doing. So I guess if we start with this idea that your diet is the beginning of your nutrition, and then you might want to add things in for specific reasons, that makes supplementing at least a plausible thing for you to do for your health potentially. Now, another thing about supplementing that comes up, and these are questions from you guys that I get on different social media platforms, is, you know, could I live if I didn't take any supplements? Generally, the answer is yes. Now, if you have a pharmacologic reason that you need a nutrient, such as you are deficient in vitamin B12, or, or you have a metabolic process that causes your body to waste a particular nutrient, well, then you, you would have to have addition of that nutrient, probably beyond your diet. Certainly, you would try and get more in your diet, but probably beyond your diet, you need more of that nutrient. If you had a medically defined deficiency state. And so that would be the first level. The next level would be background support. So let's say you've looked at the US Department of Agriculture's assays of different fruits and vegetables and animals and stuff like that. And you look at your diet and you're just not sure, maybe you're getting all of the trace minerals that you need, or maybe you're doing a lot of physical activity, a lot of You're marathoning or biking or some other thing where maybe you're going through nutrients and especially minerals quicker than your diet can keep up with. Those are other reasons people will supplement. Additionally, you might be given a supplement that is, as I said, medically indicated and it falls under the world of quote-unquote supplements and vitamins. but in reality it's more of a drug therapy. And that could be some of the vitamin D type therapies that go on. So vitamin D is really more of a steroid hormone than it is a vitamin. But it certainly— it's like vitamin A, it's characterized as a fat-soluble vitamin. And so that's how we get it. Now, if you're in the United States, there is a Dietary Supplement Act that was passed quite a long time ago. that allows dietary supplements to be sold directly to the public without going through drug approval with the FDA. They're approved as dietary supplements. So another question that I got was, well, I heard supplements are not FDA approved. Well, it's sort of, is the answer. When you look at dietary supplements, they're in what I call one food chain at the FDA, one area at the FDA in a regulatory manner. And then drugs are in a couple of other food chains, so to speak, or regulatory chains as you look at the FDA guidelines. So does a supplement, let's say your vitamin C that you're about to take, go through the same sort of testing and assessment and the randomized controlled trials and all that, that the drug you're about to take does? No, that's not how that works for the dietary supplements. The supplement has to go through an application process. There is a particular type of documentation that it has to have. So if you go on FDA dietary supplement list, you'll see they have access to all of those papers and things that they use to let something be a supplement. So in looking at it— and so sometimes you see folks on YouTube, and I've even had people who should know better miss this point. And they'll say, well, none of this is FDA approved. Well, yes, they actually are. They're just approved in a different category than pharmaceutical drugs. So that leads to the next question. And there's a whole bunch of questions I got around this particular area, but I wanted to kind of collate them together. And that is that When we look at supplements, what are the quality issues around supplements? What do I have to be worried about if I am trying to purchase supplements, etc.? Now, this is a huge issue in almost anywhere where supplements are produced. And the reason it can be a huge issue is you can, because again, they're not regulated like drugs are. They're regulated, but not quite like drugs. You could get a manufacturer or a distributor who was maybe not following the rules like they should. So there are good manufacturing practice rules, and some companies that create supplements, you know, buy into the various manufacturing practice rules, and they're very transparent about that on their websites generally. So if you go and you look and you look for certificates of quality or quality assurance, you etc., a supplement manufacturer should be able to provide that to you. So one area where this comes up where I tell people to look is in the area of fish oil, for example. So you need to know that your company selling the fish oil is checking it for heavy metals like mercury and chemicals like PCBs, etc. And if you have a a fish oil supplement, for example, that can't provide you with that information, that quality assurance information that says, yes, we do batch testing, we test for toxicity of these different types, and here's the data. Okay, your product has this amount. So it's important to know your supplier. Now, there's another issue that goes on which is highly random and variable, but that is that some online sales distributors, depending on their source, can have sources that might be counterfeit. So you could be buying what you think is, you know, a product from Brand X that you've heard really good things about, but you're buying it through a secondary or a tertiary distributor who's not Brand X the company. And then they can sell counterfeits, and that does happen in this space sometimes. There are companies that are, for example, and I'm only using these, I have no financial connection to either one, these are just examples. So there's many, many other examples. But for example, through Amazon, you can purchase things and they can come directly from that company, or they can come from a reseller. So in the case of some supplement companies, for example, Seeking Health makes a number of supplements that are very high quality. They will only provide to people buying on Amazon, for example, if they ship the supplement directly. And so you know that there's only that one step between the distributor selling it and who's making it. So that's something to look into. There are also ways if you, you know, look up online and let's say, and again, just an example, one I use a lot is Pure Encapsulations because they have little to no fillers and they're very hypoallergenic generally, etc. You can look for the best way to buy Pure Encapsulation supplements directly. The other thing that you can do, of course, is what we all used to do, and that's go somewhere locally so you can look the person in the eye who's selling it. And generally, if it's a local store, especially a health food store or something like that, they're going to be able to tell you that they buy directly from that company. So do know your sources, do check things out. And if you're going to buy a new supplement for the first time, maybe take a look at, does the company do quality control? Do they check for toxicity? Do they actually check for label claims. So if it says 100 milligrams in the bottle, are they doing assays to say each pill does have plus or minus 100 milligrams? So that's also very important to do a little bit of homework there. Now, sometimes you'll have a healthcare provider that will either recommend a particular type to you or give you a code to, you know, the company who makes it or whatever. And that can be very good because a healthcare provider has already vetted the pathway for purchasing it and they vetted the company, which is good. So all of those things help with the safety and the counterfeiting and all of that. The other thing that maybe seems self-evident, but I've seen this happen, is I've seen people, for example, they were on a particular herbal blend that worked really well for a particular health issue, something you could measure. like blood pressure, et cetera. Working, working, working. All of a sudden their blood pressure is starting to get really unstable. You ask if they're still taking those herbs and they say, oh yeah. And so then you ask to look at them and it turns out that they've found this really great deal on these herbs with the same name. And their blood pressure going out of control is because what's on the bottle, what's labeled on the bottle is not at all what's in the capsules, which happens a lot with especially herbal supplements. So again, you want You want to know your supplier, you want to know your source, and you want to make sure that they're doing quality control checks. Most of the large national supplement producers are following particular manufacturing practices as set forward by the government agencies that do regulate them. And so you just want to ask around and find out. Number one, is the source secure? Are you actually getting it from the supplier? And number two, are they doing quality control? things? Are they looking for toxicity, et cetera? So we've only got like a minute, minute and a half left here on supplements. But to summarize, yes, you should get as much nutrition out of your diet as possible. It is entirely possible in modern times with modern agriculture, which makes more food, but potentially less of certain nutrients in the food than there used to be. So for example, broccoli now versus broccoli in 1940 has different nutritional composition, and it's not always better because of the way that we farm and do stuff now. So certainly get it from your food as much as you can. What I generally recommend is that if there's no pharmacologic supplementation needed, so you don't need high-dose vitamin D or vitamin A or B12 or whatever, so there's no medical indication, you just need general backup. I will usually tell people get a good quality multivitamin mineral. A lot of times because the B vitamin content in those is kind of low, they might need a B complex on top. Depends, ask your healthcare provider. And then sometimes we'll do multi-minerals as well. So, A, just disclaimer, no medical advice being given. I'm just giving you background information and how the industry works. If you want links to all of my stuff, go on dranow.com. We do this livestream on Facebook. We do it live on CTR Radio Network, and then we are on all the pod burners, and we also put these over on YouTube as well. So you can find all of that through my D-R-A-N-O-W. And please do whatever burner or YouTube or whatever, please do like, share, subscribe, and do notifications. There's a lot of times we get kind of shoved over in the algorithm and people don't see that we're putting new stuff out. So we really appreciate all of the subscribers. I want to thank you all for subscribing. We're just about out of time here, however, so we'll be moving on to the next topic here just momentarily. And I think while the clock ticks down, the other thing I would say about supplements is, you know, if you're going to take something generally You know, like a multivitamin, you can take it by the label claim. If you're gonna take a lot of something, talk to a healthcare provider who does that. All right, we're out of time. Wanna switch over or we'll be right back?
