SUPPLEMENTS FOR WELLNESS

In this day and age we have ever increasing information about the physiology of our bodies coupled with a deteriorating supply of nutrients in our foods.  Historically, I have never really pushed supplements beyond fluoride for kids, prenatal vitamins and calcium for healthy bones.

Newer research and approaching health from the functional medicine point of view of what does our body need to have added and removed to take care of itself has expanded my recommendations.  This list has been formulated from many sources.  Most of the items appear on nearly everyone’s list.  


OMEGA-3-FATTY ACIDS: 


These are essential poly-unsaturated fatty acids.  Our bodies do not make them so we need to ingest them.  They are critical for brain and mood function.  They also have tremendous anti-inflammatory properties which is why they are helpful for arthritic conditions and the prevention of heart disease.  They lower triglycerides and make low density cholesterol molecules into higher density molecules which is heart protective as well.  Our bodies perform best at a higher ratio of omega 3 fatty acids to omega 6 fatty acids.  The fatty acids are found in protein sources.  Animals fed a “normal diet” of free range grass have a higher content of omega 3’s.  Corn fed, commercial raised animals are very high in omega 6’s.  To obtain enough omega 3 fatty acids it is best to eat cold water fish like salmon and halibut at least 2 times per week.  Many experts take that even farther and suggest 2 grams twice/day of a fish based omega 3 fatty acid supplement. To minimize burping up fish you can put your supplements in the freezer and they dissolve further down the digestive tract and are well f absorbed from there. 


B COMPLEX:  


This is a group of 12 substances lumped together because they are found in similar foods.  They are water soluble, thus your body can’t store them in fat tissue and need to be replenished daily. Your body can synthesize 4 of them, but the other 8 are “essential” and need to be taken in via food or from a supplement daily.  The B vitamins serve many roles in the body; most notably maintaining nerve function, forming blood cells, controlling substances associated with heart disease like cholesterol and homocystiene; keeping hair, skin and nails healthy and more.  B vitamins can be found in meats and dairy products and some in leafy greens.  Over cooking and exposure to sunlight diminishes their presence in those foods.  Some people may get enough in their diet, but are unable to absorb them from their stomachs. Our stomachs produce “Intrinsic factor” which is needed for B12  to be absorbed.  Conditions that cause increased acidity to the stomach (like stress, caffeine or too much alcohol) disturb the production of intrinsic factor and thus the ability to absorb Vitamin B12.  It is best to take a supplement that has the full content of B's as over supplying one may make you deficient in another.   I reccomend a sublingual product that can dissolve under the tongue.  Read the label and make sure it contains at least B12 and folic acid (folate) as well as the other B's sometimes manufacturerers separate them and that is super confusing

MAGNESIUM:  


Every cell in our body uses magnesium as a regulator element to control other minerals and jump start enzyme activity.  Magnesium deficiency can present like many other syndromes with fatigue, depression, leg cramps, anxiety, headaches, insomnia, body aches, heart palpitations, weakness and joint pain.  Magnesium is very prevalent in nuts, grains, legumes, green leafy vegetables and of course prunes.  But today’s soil has been depleted and as a result many people do not get enough magnesium despite eating the above foods.  Most resources recommend 400mg/day total (check your multi and calcium supplement they often contain 150mg or so but that's not enough).  When you go to purchase your supplement you will notice there are many forms of magnesium.  Mag citrate, mag oxide, mag gluconate etc.  It is recommended to take Mag citrate or mag aspartame as they are the most absorbable.  Ideally this supplement should be taken with food and in combination with Vitamin D and calcium for best absorption.  Ingesting magnesium oxide may cause diarrhea.  Alternatively, soaking in Epsom salts (magnesium oxide) is another great form of absorption.  Topical gels are also available.  It can take up to 6 weeks to notice benefit from replacing magnesium

VITAMIN D:


Vitamin D is found in many dietary sources, such as fish, eggs, fortified milk, and cod liver oil. The sun also contributes significantly to the daily production of vitamin D. The term "vitamin D" refers to several different forms of this vitamin. Two forms are important in humans: ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). Vitamin D2 is synthesized by plants. Vitamin D3 is synthesized by humans in the skin when it is exposed to ultraviolet B (UVB) rays from sunlight. Foods may be fortified with vitamin D2 or D3.  The major biologic function of vitamin D is to maintain normal blood levels of calcium and phosphorus. Vitamin D aids in the absorption of calcium, helping to form and maintain strong bones. It acts like the glue that helps the calcium stick to the bones which is why it is suggested to increase bone mineral density and decrease fractures. Recently, research also suggests that vitamin D may provide protection for mood disorders, muscle weakness and pain, hypertension (high blood pressure), cancer, and several autoimmune diseases. Symptoms of vitamin D deficiency could be described as chronic pain, insomnia, weak bones, frequent infections, depression, etc. However, most people are not aware they are deficient as those symptoms are common to many conditions.
Part of the problem today is that many people do not get enough sun exposure as they work indoors.  Further using sunscreen, which is very important for skin protection, prevents the skin from making vitamin D.  Of note, our latitude on the planet, here in Santa Cruz, is not the best for the angle of light to produce Vitamin D in our skin.  Almost every vitamin D level I have checked in non-supplemented people has been low.
Vitamin D supplementation is easy and affordable.  I suggest everyone take at least 1000 mg daily.  If levels are checked and found to be very low then we often prescribe a mega-dose weekly and recheck levels.  If you are experiencing fatigue, muscle aches or depression, get your level checked.  Please note it takes at least 2 months to notice improvement of symptoms when replacing or increasing. 


ZINC: 


Zinc is an essential trace mineral and micronutrient that is found throughout the human body, mainly in the muscles and bone. More than 100 enzymes require zinc in the metabolization of nutrients such as carbohydrates, fatty acids and proteins. Zinc is necessary for normal growth and development during pregnancy, childhood, and adolescence. A dietary restriction in zinc during these periods increases risk of cardiovascular and renal disease in adult life.  Zinc is also involved in: immunity, wound healing, sense of taste and smell, vision, prostate gland health, inflammation, acne, atherosclerosis, ADHD and myopia (nearsightedness).
Zinc is found in foods, such as red meat, poultry, shellfish, oysters, whole grains, beans, nuts and fortified cereals.  It should be noted that the zinc in the vegetarian sources are bound in such a way that they are poorly absorbed.
Current formal recommendations for Zinc supplementation are about 10mg/day; however most experts feel this is insufficient, again due to the diminishing supply in our food.  You can get zinc supplements in 25mg and even 50mg doses.  I suggest 25mg every other day.   Most multivitamins contain zinc. check the amount of zinc before supplementing. More modern formulations do contain more than 10mg.  Caution should be noted that rarely, too much zinc can prevent your body from absorbing other trace minerals like copper and even more rarely be toxic so we do need some, more than most of us get but not lots.


CALCIUM: 


Calcium is the most abundant mineral in the body. Calcium is required for vascular contraction and vasodilation, muscle function, nerve transmission, intracellular signaling and hormonal secretion, though less than 1% of total body calcium is needed to support these critical metabolic functions. Serum calcium is very tightly regulated and does not fluctuate with changes in dietary intakes; the body uses bone as a reservoir and source of calcium, to maintain constant concentrations of calcium in blood, muscle, and cells. This is why we tell you that calcium on your blood test is not reflective of your bones and rather we order a bone density test.
The remaining 99% of the body's calcium supply is stored in the bones and teeth where it supports their structure and function. Bone itself undergoes continuous remodeling, with constant resorption and deposition of calcium into new bone. The balance between bone resorption and deposition changes with age. Bone formation exceeds resorption in periods of growth in children and adolescents, where as in early and middle adulthood both processes are relatively equal. In aging adults, particularly among postmenopausal women, bone breakdown exceeds formation, resulting in bone loss that increases the risk of osteoporosis over time.
 
Calcium is found in some foods, added to others, available as a dietary supplement, and present in some medicines (such as antacids). Adults should have about 1,000 mg of calcium/day (1200mg if you are a post-menopausal woman or adolescent)  It is very easy to get enough calcium through diet.  Foods rich in calcium include dairy (especially yogurt, hard cheeses and milk), bone-in fish like sardines, and fortified products like bread, tofu and orange juice.  Many leafy greens have a decent amount of calcium but usually on the order of 100mg or less per serving.  Kale has the most!  One caveat also is that cottage cheese, ice cream and cream cheese have less than the leafy greens/serving!
 
If your diet is not rich in these foods then many supplements are available. The two main forms of calcium in supplements are carbonate and citrate. Calcium carbonate is more commonly available and is both inexpensive and convenient. Due to its dependence on stomach acid for absorption, calcium carbonate is absorbed most efficiently when taken with food, whereas calcium citrate is absorbed equally well when taken with or without food.  Many supplements come combined with Vit D, magnesium and zinc.  Keep in mind your body can only absorb 500mg of calcium at a time so spread out supplements with breakfast and dinner.  And, if you are able to get a serving of a calcium rich food, like yogurt, don’t take a supplement with that meal, it will be wasted.  
Finally, a recent study showed that there may be a risk of heart disease if we get too much calcium in supplement form.  So stick to the guidelines and try to get it mostly through food.

All that said FOOD is still the best source for for nutrition.  Eating freash non processed real food in a vraiety of colors will get you most of what you need.  Read labels.  Ask questions.  Be smart!!!!
 

Yours,

Amy Solomon