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Supplementation

I remember in med school (I was impressionable) and a Faculty physician gets up on that stage and made a statement to the effect “people who take supplements have expensive urine”. And to a certain extent what he said is true, urine will be expensive, because the kidneys clear most of the products once we are done using them, out of our system. But the implication that supplements travel through the system with no effect is completely inaccurate, and I would tell you that I think that guy was dead wrong.

Supplementation is complex. There are certain supplements that I think everyone should take and for the purpose of this brief introduction, I am going to cover those three things. There are a number of supplements that I think almost make that list, they’re so impactful and probably can benefit just about everybody, but I recognize that some people will not be able to tolerate high level supplementation without “pill fatigue”.

Supplementation is the easiest Cog in the Wheel of Wellness. It may not be the most impactful, but it’s certainly easier than not eating what you want or not eating too much. It is definitely less painful than exercise. It’s something you can start right now to have an impact on your long-term health.

The No-Brainers

If you’ve made it this far, you know that I’m a big believer in the importance of the Microbiome. A high-quality probiotic, individually blister sealed in nitrogen, so that is not exposed to oxygen before you take it, is the first step. Bacteria that live in the intestines can’t survive in the presence of oxygen, so the bacteria that we want to colonize our intestines will need to be safe from exposure to oxygen. Those same Microbes cannot survive a pH of 2, which is the typical Acidity of the stomach, so a high-quality probiotic should have a specialized capsule that resists digestion until it reaches the intestine, which is where we want the bacteria. Finally the bacteria need to be in high-quantity and proven quality.

The Microbiome is implicated in food allergy through mechanisms relating to a leaky gut. It is also correlated to obesity, depression, cognitive function, energy levels and immune function. The list is longer, but those are important aspects. It’s a no brainer that you should take a high-quality probiotic as you need to have a healthy Microbiome.

Vitamin

Vitamin D with another vitamin called K2 is an inexpensive supplement that is universally low in almost all Test subjects. K2 directs the calcium to our bones and away from our blood vessel so we definitely want to have K2 with our vitamin D. Vitamin D is a pro-hormone, involved in all kinds of cellular metabolism. It’s massive involvement in our immune health was well demonstrated during the Covid Pandemic. Low Vitamin D was strongly correlated with bad outcome. There is science demonstrating effects in metabolic health, bone health, mood and obesity. Vitamin D is very inexpensive.

The final no-brainer on my list of three is Marine Fish Oil. High quality, molecularly distilled (so there’s no mercury) Marine fish oil from small, cold water fish, like sardines, anchovies, herring and pollock should be included in everyone’s supplement regimen.

Small, cold water fish are the source we want as they don’t concentrate mercury like large predators. The main function of taking fish oil as a supplement is to replace two blood fats that were likely very high in our diet, Paleo-biologically. These two important fats tend to be very low in our agricultural-based diet. We used to consume a lot of quantity of food from the ocean. Most of our existence as a species has been on the coast, having moved inland only recently, and most people fall short in a normal diet and will not consume enough DHA and EPA. These are two omega-3 fatty acids that are found in high concentrations in marine fish and other marine life. Those two fatty acids compose our cell walls, actually about half our brain by weight, and they impact our inflammatory state. If we can transition our cell walls so they are composed of those omega-3 fats instead of the omega-6 fats that are found in many of the agricultural sources of food like corn and wheat, we reduce the inflammation associated with injury and illness. When we have an insult that causes an immune reaction, the prostaglandins and leukotrienes, fancy words for chemical messengers that signal our body to have inflammation or not, will be produced based on the fatty acid composition of our cell walls. Those products will be inflammatory if they’re made from omega-6 and anti-inflammatory if they’re made from omega-3’s. We know the inflammatory state is a driver of all badness; blood vessel disease causing heart attack and stroke, cancer, dementia, frailty and metabolic diseases all correlate to the inflammatory state. We need to have a healthy balance in our cell walls to have our best outcome. High quality marine fish oil at reasonably high doses will accomplish this. We know that fish oil can improve memory, joint pain, immune function and decrease risk of cardiac death.

Other supplements that nearly make the no-Brainer list:

  • Berberine which is excellent for improving insulin sensitivity, lowering LDL cholesterol and lowering triglycerides, is a plant-based alkaloid as effective as Metformin for treating Type II Diabetes. Anyone with risk of Type II DM should take this daily. A lower Hemoglobin A1c will result in decreased glycation and slowing of that driver of aging. It is reasonable to consider in all persons. 1000mg daily was used in the study showing these benefits.
  • Highly Bio-available Curcumin has been shown in a double blind clinical controlled trial to slow the speed at which people develop amyloid in their brain, highly correlated to the presence of Alzheimer’s dementia. The same double blind study also showed positive functional outcomes in those individuals in the treatment group (better global memory and attention span). Considering that it has great evidence for reducing joint pain, pretty tempting to hedge the bets against Dementia with this one.
  • B vitamins can be helpful in many individuals. Some people handle B vitamins very well and have very good genetics and may not get a lot of benefit from supplementing, especially if they have a high quality diet rich in fruits and vegetables. However, many people will find this is a difficult area and some simple lab tests that we follow routinely can indicate if there is trouble. Following these labs, I typically see improvements in these Biomarkers with supplementation.
  • Magnesium is dirt cheap. It can help with sleep and muscle cramps. The first thing I went to when I was an ER doctor and I thought somebody was having a heart attack. I gave them 2 g of magnesium because it prevents arrhythmia, which is frequently what causes death during a heart attack. Makes sense at 500mg as a night time dose before bed.
  • Melatonin is inexpensive and a lot of people will benefit. Melatonin declines as we age. There were studies that suggested melatonin supplementation resulted in better outcomes with Covid. Many people will note improvements in sleep.
There’s a number of supplements that you can take that may impact longevity. I will cover a longer list in a different venue.
Cliff notes:
  • Don’t miss your vitamin D3 with K2
  • Take a Quality Probiotic and address the Microbiome
  • Make sure you’re taking molecularly distilled, Independent third-party tested highly concentrated, Marine Fish Oil to shift the inflammatory state.

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