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Supplements in the spotlight

Reading time: 13 minutes

Confused about supplements? Dr Jenny Goodman has the lowdown on why we need them, how to choose a top-quality product and the ingredients to avoid

Do we need nutritional supplements? The short answer is some of us do, some of the time. But why? Why can’t we get all the nourishment we need from food?

The reality is the soil in which our food is grown has been depleted of nutrients by decades of intensive farming with fertil­izers and pesticides. Then our food is transported, stored and wrapped in plastic. And many of us are not digesting or absorbing it well.

Also, the amount of nutrients our bodies require has been greatly increased by stress, pollution and numerous other aspects of 21st-century life. So the gap between what we need and what’s in our food is growing wider.

Supplements can never be a substitute for good food, fresh air, exercise, sufficient sleep and so on. But they may be a necessary add-on to those things at certain moments in our lives.

Here’s what you need to know about how to choose them—what to look for, what to avoid—when to take them and which ones you can combine.

Choosing a supplement

When choosing supplements, you are looking for maximum nutrients with minimum rubbish—and finding this is a challenge.

By “rubbish” I mean the astonishing amounts of fillers, flavors, colors, coatings, binding agents, lubricants, thickeners, stabilizers, preservatives and anti-caking agents that many cheap supplements contain.

Some of these substances are also used in the building and decorating trades, and in cosmetics. Pharmaceuticals often contain worse additives and more of them. You don’t want to be swal­lowing these chemicals along with your vitamins and minerals; it defeats the object.

They are put in there primarily to make life easier for the purveyors of mass-market supplements: they allow the manufacturing process to be totally mechanized—quicker, cheaper, less labor-intensive. And by filling up their capsules/tablets with bulking agents, manufacturers put more money into their own pockets, but more rubbish and fewer nutrients into your body.

So here are some tips to avoid the junk and get a higher proportion of nutrients from your supplements.

Beware the seller. Don’t buy your supplements from the supermarket or chemist. Don’t even go to the kind of health-food shop that sells only its own brand of supple­ments.

Go to a health-food shop that stocks a wide variety of brands, take your time and take your magnifying glass! If buying online, make sure you do your research on the brand and product you want to buy first.

Read the label carefully. Don’t just look under “Nutritional Information” or even where it says, “This tablet contains.” Those sections will tell you about only the nutrients, not the junk. You need to read the actual ingredients list.

If the supplement you’re looking at comes in a box, remember, a box has six sides; you may need to read all six of them to find the complete ingredients list, and it may be in tiny print.

On the bottle of one popular multi-vit marketed at children, I searched in vain for the full ingredients list. Eventually I realized that I had to pull back a tiny, well-hidden flap and unpeel the label to reveal a lot of stuff I wouldn’t want anybody’s kiddies swallowing.

If ordering online, make sure you can see the full ingredients list—not just what’s in the capsule but also what the capsule itself is made of. If you find yourself interested in a particular product, look at the ingredients of a few other supplements made by the same company; you’ll get a clearer idea of how much they rely on artificial additives.

Bear in mind that better-quality supplements (more nutrients, less rubbish) cost more.

Watch out for additives. See below for some of the additives commonly used in nutritional supplements. Some are harmless, some are not, and on some the jury is still out.

Consider the capsule. There tends to be less junk in capsules than in tablets (less need for sticky “binders”), but what is the capsule shell made of? Here there is very little wriggle room.

It tends to be either a vege­table source or gelatin. “Vegetable” capsules are made of one or more of the following three compounds, all synthetic:

Microcrystalline cellulose. This sounds like plant fiber, and essentially it is, but it’s more like wood pulp than a leaf. It seems most people can cope with it.

Hypromellose. This is short for hydroxy-propyl-methyl cellulose (HPMC). It’s also from plant fiber but problematic for some people.

Cross-linked cellulose gum. This is also known as sodium croscarmellose or sodium carboxy-methyl cellulose (CMC).

Most people’s digestive systems can manage these, but it’s a ques­tion of quantity. Smaller capsules are easier to swallow, of course, and easier on the gut all the way down.

Sometimes you can open the capsules and mix the contents with water or food (e.g., yogurt), but only if the product says you can. Responsible manufac­turers will tell you on the packaging or the bottle whether it’s safe to do this. It often is, but never in the case of digestive enzymes or hydrochloric acid supplements that could burn the esophagus.

The other material from which capsules can be made is gelatin. This is a far more natural substance and easy to digest, but it comes from a pig (or sometimes a cow), so of course it’s not acceptable if your diet is vegetarian, vegan, kosher or halal.

Occasionally you can find capsules made of fish gelatin, which would be fine for people whose diet is kosher or halal.

Check ingredient order. The order in which the ingredients are listed is important. Whatever’s first, there’s most of that. If the first two or three ingredients on the list are some version of sugar or bulking agents like calcium carbonate, or if you see more than two or three of the dodgier items on the additives list, then save your pennies and put it back on the shelf.

The vitamins, minerals or essential fatty acids you are after should be first on the list, not right at the end in tiny amounts among a load of “E” numbers. On the other hand, if an ingredient constitutes less than 1 percent of the total contents, then it doesn’t have to be declared on the label at all.

Get liquid or powder forms. This means you haven’t got the capsule shells to contend with. This isn’t possible for all supplements, but where it is, it can be easier on your gut. Liquids are better absorbed anyway, especially minerals like zinc, selenium, chromium and manganese.

Check dosages of each nutrient. More is more when a supplement contains multiple nutrients; you want maximum nutrients and ideally zero junk. But what dose of each nutrient do you need? This depends on your age, weight, sex and health situation, but below is some general guidance.

Recommended daily amounts

The government produces recommended daily amounts or allowances (RDAs) for most nutrients. In the UK, for vitamins and minerals, these are now called nutrient reference values (NRVs). But the numbers are the same, and you can easily look them up. They represent the amount an average healthy adult needs to avoid deficiency.

In the US, the term Daily Value (DV) is used to simplify labeling. It represents both Daily Reference Values (DRVs, the amount a 2,000-calorie diet should include) and Reference Daily Intakes (RDIs, the amount likely to meet nutritional needs of a healthy person of a certain type, such as a pregnant woman or a man over age 60).

These recommendations are still based on the outdated science I learned in medical school, namely that we just need vitamins to prevent deficiency diseases. So the UK government recommendation is, for example, 1 mg of vitamin B1 (thiamine) daily for men and 0.8 mg for women. The US government recommends 1.2 mg daily for men and 1.1 mg for women.

These amounts will indeed prevent you getting beriberi (a disease caused by thiamine deficiency). But they don’t take account of the fact that you may be losing B vitamins from stress, or from excessive consumption of alcohol or refined carbo­hydrates. Nor do they consider the wide spectrum that exists between total health and a full-blown, fatal deficiency disease.

The recommendations also don’t take into account the great biochemical variation between individuals, which means different people have vastly differing requirements for particular vitamins and minerals. Genetic testing and clinical expe­rience demonstrate this again and again.

Similarly, the UK government’s recommendation of 1.5 micrograms (mcg) of vitamin B12 daily and the US Daily Value of 2.4 mcg daily will prevent most people from getting pernicious anemia, but for some people they are not nearly enough for optimal mental clarity and physical energy.

And while the UK government’s NRV for vitamin C, 40 mg a day, and the US recommendation of 90 mg will stop you getting scurvy, these are not enough to ward off infections or late-life gum disease or cancer. And they ignore the fact that the vitamin C we take in gets destroyed by tea, coffee, cigarettes, alcohol, paracetamol and stress.

On most supplement bottles, you will see what percentage of the government’s recommended amount that supplement gives you. Some supplements provide, for example, the B vitamins at levels quite close to the government’s recommendations, 1–2 mg for most of them. Others supply 50 mg or even 100 mg of most of the B vitamins.

The lower doses optimistically assume perfect absorption from the gut. The higher doses don’t rely on good absorption, but they do rely, correctly, on the fact that the B vitamins, like vitamin C, are water-soluble; you can’t overdose because you simply pee out what you don’t use.

So if you see that the amount of B12 in a supplement is 1,000 percent or even 10,000 percent of the government’s recommendation, don’t panic. It’s because the recommended amount is tiny, not because the supplement is over the top.

So in terms of the B vitamins, most people are fine to take the doses found in any good-quality, junk-free B complex, which usually contains 50 mg of most members of the B group.

Needs for vitamin C vary hugely; some people are fine with 500 mg twice a day in winter and none in the summer. Others need vastly more and benefit from it.

With the minerals and the fat-soluble vitamins, more caution is needed, as overdose is theoretically possible. For vitamin A, the UK government recommendation of 700 mcg (2,333 IU) daily for men and 600 mcg (2,000 IU) for women and the US Daily Value of 900 mcg (3,000 IU) are in fact enough, and we can get it from food, so we don’t need it in a supplement.

With vitamin D, the amount you need really should be determined by a blood test result; you want to keep your blood level of vitamin D between 75 and 200 nmol/L. For most people this means taking about 50 mcg (2,000 IU) each evening through the winter, but none in the summer.

As for minerals, the UK government recommends 300 mg of magnesium daily for men and 270 mg for women, and the US government suggests 420 mg. These amounts are fine, but they assume we can get all that from food and absorb it all. In practice, we lose vast amounts of magnesium through stress.

The most important thing in choosing a magnesium supplement is what the magnesium is combined with (all minerals have to be combined with something). Magnesium carbonate and magnesium oxide are pretty useless.

Far more effective (because they’re better absorbed) are magnesium citrate, magnesium fumarate, magnesium malate, magnesium gluconate or magnesium chelated (combined) with an amino acid, like magnesium taurate or magnesium bisglycinate.

Regarding zinc, the UK government’s recommendation of 9.5 mg per day for men and 7 mg for women, or 11 mg in the US, is not quite enough for most of us these days. I would suggest 15 mg per day, and that’s what most supplements provide. Zinc is drained out of our systems by the toxic metals, like nickel, cadmium and mercury, that surround us in an industrialized envi­ronment.

My favorite brands

There are dizzying numbers of supplement companies out there, and new ones are popping up every minute. Even professional nutritional practitioners can’t really keep up. I recommend prod­ucts by about 20 different companies (and have absolutely no commercial or financial links with any of them).

Besides the points discussed above about minimal junk and maximum nutrient content, one useful criterion is whether the company has a technical depart­ment, staffed by nutritional therapists, that you can phone up and ask for advice. They should have.

At the time of writing, these are my favorite brands in the UK:

  • Viridian products are very pure and ethically made, plus the vitamin D and vitamin K supplements come in really tiny capsules.
  • Metabolics offers a very pure catalogue, and its experts are very knowledgeable and informative.
  • Pure Bio supplements contain no junk.
  • BioCare is particularly good for liquid minerals, vitamins B and C, assorted gut treatments and children’s products.
  • Nordic Naturals is a Scandinavian company that specializes in fish oils

In the US, these are some good brands that offer a vast range of supplements:

  • ARG (Allergy Research Group)
  • Biotics
  • BodyBio
  • Jarrow Formulas
  • Life Extension
  • Pure Encapsulations
  • Seeking Health

The latter two are my favorite American brands in terms of purity (i.e., no junk).

I must stress that all this is only at the time of writing. It’s a field that changes fast. At any moment, a new and even better company might pop up.

And, more worryingly, at any moment a currently very good company could get bought up or taken over by a pharmaceutical firm or other corporation—it does happen—and the next thing you know, they’re increasing their profits by stuffing the capsules with chalk (calcium carbonate).

So this advice can only be a snapshot; don’t take it as gospel. Always do your own research and check labels carefully.

Choosing probiotics

Here, it really is a case of “more is more.” You want at least 10 billion viable organisms, lots of living friendly bacteria. The greater the numbers, the greater the chance that some of them will hang around and take root. It’s a bit like scattering seeds. Most of them won’t “take,” so you need to maximize the chances.

Look for a wide range of species of Lactobacillus, such as L. acidophilus, L. rhamnosus, L. plantarum and L. bulgaricus, and some Bifidobacterium species such as B. longum, B. bifidum, and B. breve. B. infantis is particularly helpful for new babies who for one reason or another aren’t being breastfed, and for babies who were unfortunately given antibiotics at or soon after birth.

Multivitamins and minerals

If they are top quality, multivitamins with minerals may be useful as a stopgap measure for a while. But they can have several drawbacks.

Firstly, they may contain incompatible elements. For example, if they have both zinc and iron, the iron will stop the zinc being fully absorbed. And if they have both calcium and magnesium, the calcium will stop the magnesium being fully absorbed.

Secondly, if they contain vitamin A, there is a risk of overdosing if you take them for a long period. Thirdly, many multivitamin and mineral supplements often don’t contain enough of anything to make a significant difference.

Supplements for children

Beware supplements disguised as sweeties—they may in fact be sweeties disguised as supplements. Watch out for sugar, artificial sweeteners and artificial colorings.

Healthy kids don’t need supple­ments anyway. They need good food, more sunshine and less screen time. Poorly kids may need supplements, and nutritional practitioners find that what most unwell children are lacking is zinc, magnesium, the B vitamins and vitamin D. Sometimes iodine and vitamin C are needed as well, particularly in those who keep getting infections.

A few drops of the relevant nutrient in water (or very dilute fruit juice if really necessary) may do the trick. With kids who are fussy eaters, some zinc drops daily for a few weeks can sometimes work wonders—they may even start eating broccoli without bribery!

And a good kiddies’ probiotic supplement can often sort out a tendency toward tummy aches and diarrhea or constipation. But, of course, you must consult a health professional if your child is persistently unwell.

Supplement additives

Here are some of the most common additives you’ll find in supplements.

Talc. I kid you not. Yes, it’s talcum powder.

Stearic acid or magnesium stearate. It’s a saturated fat used as a lubricant. A few people, often those with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS), have allergic reactions to it. But it’s one of the hardest to avoid.

Titanium dioxide. A white dye used in paint and sunscreen and as a food coloring. Totally unnecessary and best avoided.

Dicalcium phosphate. This may well turn out to be problematic due to its heavy metal and radioactive material content.1

Potassium sorbate. A preservative that can spark off hay fever or asthma in certain sensitive individuals.

Ascorbyl palmitate. Another lubricant, a synthetic form of vitamin C often used as a supplement and as a preservative in baby formula.

Methyl paraben. This preservative and fungicide is also an estrogen mimic and an anti-androgen (in other words, it can disrupt hormones).

Citric acid. Don’t imagine they get this by squeezing oranges and lemons. They make it from mold.

Benzoic acid / benzoate. This is fine for many people in small amounts, but some people do have allergic reactions to it even though it is a naturally occurring substance.

Sucralose (Splenda). An artificial sweetener made by taking a molecule of ordinary sugar, sucrose, and replacing three of its hydroxyl (hydrogen + oxygen) groups with chlorine atoms. Research shows it may well be problematic,2 and not just for the individuals consuming it. At high temperatures, such as in municipal incinerators, it decomposes to produce dioxins and dibenzofurans,3 which are carcinogens as well as endocrine disruptors and are among the deadliest chemicals known.

Dioxins are the chemicals that were released in the Seveso disaster of 1976. Thousands of animals died, and several children were taken to the hospital. Effects on adults included the skin disease chloracne and, still many years later, an increased rate of cancer and diabetes. Low sperm counts were also present in young men who had been in the womb at the time of the accident.

Caramel. Burnt sugar.

Maltodextrin. Glucose syrup, a synthetic starch—effectively a form of sugar.

Flavors / natural flavoring. This could be anything. They’re not legally required to tell you. “Natural” and “natural source” have become virtually meaningless in this context. Even when something comes from a natural source, chemical processing can turn it into a different substance with totally different properties.

Guar gum. A thickening, stabilizing powder made from guar beans.

Acacia gum. Gum arabic, probably okay for most people.

Iron oxide. Essentially this is rust, a probably harmless but needless coloring.

Silicon dioxide. This is silica, used as a harmless anti-caking agent.

Calcium carbonate. This is basically limestone, or chalk. Although it’s harmless in itself, if it’s the first or second ingredient on the list, then it’s being used as a cheap filler, and you are getting much less actual vitamins or absorbable minerals.

Glycerol/glycerine. A sweetener.

Supplement Q&A

How should I introduce supplements?

Always introduce new supplements one at a time, i.e., one new one per day, to be sure each supplement agrees with you.

What times of day should I take supplements?

Here’s a good basic schedule:

  • With breakfast, take B-complex vitamins, vitamin C and probiotics.
  • With dinner, take zinc, magnesium and vitamin D.

In my experience, people often forget to take supplements at lunchtime, so I’ve almost given up suggesting this.

How long should I take them for?

Vitamins B and C, probiotics and probably magnesium can be taken indefinitely if you find they help. But with all other minerals, and with the fat-soluble vitamins and essential fatty acids (omega-3 and -6), it is possible to overdose. So either get yourself tested to track your levels of these nutrients or take them seasonally as needed.

Adapted from Staying Alive in Toxic Times: A Seasonal Guide to Lifelong Health by Dr Jenny Goodman (Yellow Kite, 2020). Reproduced with permission from the publisher through PLSclear. Copyright © Jenny Goodman 2020

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References
  1. J Hazard Mater, 2009; 170(2–3): 814–23
  2. J Toxicol Environ Health B Crit Rev, 2023; 26(6): 307–341; J Toxicol Environ Health B Crit Rev, 2013; 16(7): 399–451
  3. Sci Rep, 2013; 3: 2946
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