How to Talk to Your Patients About the Dangers of Self-Supplementation

by Dr. Justin Gallant ND | Follow on Twitter

Don’t let your patients waste their money and potentially harm themselves with supplements.

THE RISKS OF SELF-SUPPLEMENTATION can vary from a waste of money to severe drug interactions and nutrient depletion. Here are the top 10 reasons to inform your patients about the dangers:

  1. Self-supplementing can be just as dangerous as self-prescribing or self-diagnosing. 
  2. Health food store employees often don’t have the education or experience in clinical nutrition. 
  3. Labels can be deceiving and confusing. 
  4. There are more products out there that have negligible doses than those with appropriate doses, don’t be fooled. 
  5. Not all supplements and vitamins are safe, some are absolutely contraindicated for certain people. 
  6. The media (news, TV shows, etc…) are more interested in thrilling an audience rather than doing legitimate research. 
  7. Don’t believe everything you hear, when in doubt ask your local ND. 
  8. Some supplements are targeted towards specific populations or conditions but when you look at the ingredients they’re just repackaging a multi-vitamin or a single nutrient, calling it something else and charging way more. 
  9. I would prefer all of my patients get their nutrients through whole foods but those who are deficient or can’t get them from whole foods should be taking appropriate supplements. 
  10. If you’re going to be spending $100-$1000’s on supplements each year, it would be wise to know which ones are appropriate or not.

Let’s learn more about these concerns and how to explain them to your patients.

Negligible doses

  • The majority of supplements that are available at chain stores/pharmacies have negligible doses, terrible toxic fillers and may be harming you as well as your bank account.
  • A common example of this that I see quite often in practice is with Vitamin C and Fish oil (see below). 
  • Most research done on vitamin C uses a dose around 2g per day but certain multivitamins and even pure vitamin C supplements contain less than 100mg (this is 20x less than what most research uses)
  • The picture below is a perfect example (I’ve excluded brand names for legal reasons). An optimal dose for Omega 3 fish oil should contain ~2g EPA and 1g DHA. EPA and DHA are the active ingredients in fish oil. The first label is a common brand found in everyday health stores and pharmacies, while the second label is a high quality company that may be a bit harder to find and more expensive. If you compare the labels the first says “1g of fish oil” but if you look further down it only has 154mg of EPA and 400mg of DHA. The ratio of EPA to DHA should be at least 2:1 and to get the appropriate amount of EPA from this supplement you would have to take about 13 soft gels per day.
  • A common scenario: A large Nutraceutical company invests millions of dollars into a study involving a certain extract, they then publish their results and another company comes up with a product using that extract but in a negligible dosage.
3286351_orig     A common fish oil brand (top) would require 13 soft gel capsules per day to get the appropriate therapeutic effect versus a professional brand (bottom) that requires 2 capsules.

A common fish oil brand (top) would require 13 soft gel capsules per day to get the appropriate therapeutic effect versus a professional brand (bottom) that requires 2 capsules.

Lack of proper knowledge

  • Just because someone works out and looks healthy doesn’t necessarily mean they know what they’re talking about. Bodybuilding forums have increased the demand for nutraceutical companies but getting advice from friends or online forums is dangerous. The paradox of the internet is that those who are qualified know they shouldn’t give individuals medical advice over the internet and those are unqualified are the ones who give medical advice over the internet.
  • As part of my health intake I ask patients to bring in all of their medications and supplements so I can see what they are taking. This allows me to make sure there aren’t any potential interactions and gives me a chance to teach them what to look for in proper supplements so they aren’t wasting their money or putting their health at risk.

Interactions

  • Myth: All vitamins and minerals are safe; you’ll just pee out what you don’t need.
  • Fact: There are several interactions natural health products can have with specific medications or conditions.
  • Fact: Certain minerals and nutrients counterbalance other ones (i.e. Zinc and Copper, Calcium and Magnesium). Thanks to nature, most of these balances are accommodated for in whole foods. Some supplements however, don’t take these balances into consideration.

Deceptive marketing

  • Labels can be very deceiving and confusing
  • A couple things to be aware of are dosages, nutrient form (i.e. magnesium citrate vs magnesium oxide), source of the nutrient and serving size.
  • Serving size is very important because you could be comparing 2 labels but one might be for 4 capsules so it might look like they have the same amount but in reality it could have a fourth of the dose of the other.

Contraindications

  • There are numerous conditions which are contraindicated with certain supplements. Some contraindications are relative and some are strict. This is the main reason why giving medical advice to someone when you don’t know their health history is dangerous.
  • A few examples are psoriasis and vitamin C, Licorice and high blood pressure or fiber and any medications.

Improper research extrapolation

  • This is the case most of the time you hear about a supplement in the news
  • A common example of this: Researchers find “substance x” kills cancer either in vitro or in mice, media tells the world “substance x” kills cancer.
  • Usually when this type of situation occurs “substance x” will be headlining the news and on the front page of newspapers one day, have it’s own section at a health food store the next day and then someone properly interprets the research within a week or so but that just trickles into the news.

You don’t necessarily get what you pay for

  • There are a lot of deceptive supplements out there. Some who target vulnerable populations will charge through the roof but when you look at the ingredients they are just a typical multivitamin with negligible doses.
  • An example of this are some supplements targeted for those who are infertile, bipolar, or have kids with autism or ADHD, etc. There are also simple supplements out there for conditions like restless leg syndrome that just contain an single ingredient like magnesium citrate which you can buy for a fifth of the price.

My views

  • Supplements should be used as a crutch while we restore ourselves back to health. They are a good way of replenishing stores if you’re deficient in a certain nutrient but you should eventually get your nutrition from your diet.
  • There might be a smaller dose in the food you eat compared to a supplement but there are other constituents in that food that will help you utilize that nutrient properly. A good example of this is iron. When you eat a nice juicy steak you have protein and the consequential acidity that will help you absorb the iron. This concept of the symbiosis of nature holds true for most whole foods
  • There are some great companies out there that take into consideration proper dosage, common allergens and sensitivities, toxicity, harmful fillers among other important aspects. We should be supporting these companies, not the scoundrels who are selling terribly made supplements.

Personal self-supplementing story

  • Before I took clinical nutrition I was taking 2g of vitamin C each day for general health. My mindset was: I heard 2g is the proper dose and it’s vitamin C, a pretty tolerable vitamin for all. I wasn’t sure if it was a coincidence or not but every time I started taking vitamin C I would get sick with an upper respiratory infection.
  • During my studies at the Canadian College of Naturopathic Medicine I realized the reason I was getting sick was because vitamin C increases iron absorption and bacteria thrives off of iron. Since my iron levels were really high due to a genetic condition called Hemochromatosis my self-supplementation led to my system being a breeding ground for bacteria. This might seem like an obscure example but it’s just one of hundreds of reasons why you shouldn’t generalize your health care.
About the Author
Dr. Justin Gallant ND

Dr. Justin Gallant believes the ideal healthcare setting is when a patient has a multidisciplinary group of healthcare providers looking after them and each member of the group can communicate openly with each other. Each healthcare provider has their own limitations so it is important to work together in order to fill these gaps. Dr. Gallant is currently working at Advantage Chiropractic as well as Mountain Wellness Centre in Hamilton, Ontario.