Worry?—no. Supplements have a remarkable record of safety. Give it careful thought—yes. Here are some things to consider.
When planning a supplement regime, you should seek good professional advice. If you don’t already have a good professional advisor, a place to start would be physicians belonging to one of the organizations listed below. They generally use and are expert about supplements and integrative medicine in general:
- American Association of Environmental Medicine
- American Association of Naturopathic Physicians
- American College for the Advancement of Medicine
- International College of Integrative Medicine
In addition, there are some basic questions that you should ask yourself:
- Is this the right form of the supplement?
- Is it natural or synthetic?
- Are there co-factors that must be taken with it?
- Do I trust the company selling it?
- Am I taking the right amount?
Let’s take each of these in turn.
1. Is this the right form of the supplement, and is it natural or synthetic?
The sister publication of the Archives of Internal Medicine, the Journal of the American Medical Association, just released a study suggesting that vitamin E supplements increase prostate cancer risk for men. The results of the study are puzzling. Taking 400 IU of vitamin E seemed to increase risk; so did taking 200 mcg of selenium. But when men received both the vitamin E and the selenium together, the risk was about the same as taking nothing at all.
The real problem here, however, is the form of the vitamin, which was synthetic alpha-tocopherol. In our article last February, Jonathan Wright, MD, explained that nature does not give us isolated alpha-tocopherol. It gives us a mix of alpha-, beta-,delta-, and gamma tocopherols, and that too much alpha interferes with what seems to be the more important gamma form of the vitamin. In another article, our scientific director Rob Verkerk further explained that synthetic alpha-tocopherol is not a good substitute for the natural form, and that tocopherols in nature are always accompanied by the tocotrienols.
What is true for tocopherols is true for other vitamins. If we take extra beta-carotene, we should take other carotenes to balance it. If we take more of a B vitamin, we will probably need more of other B vitamins to balance it. This is one of the problems with trying to apply drug trial methods to supplements. It isn’t one supplement that helps or hurts us. It is achieving the right balance through food, supplements, and exercise.
The Archives of the Internal Medicine study covered elsewhere in this newsletter claimed that supplementing with copper might be particularly risky. This is probably correct, since copper acts as a pro-oxidant and too much of the metals can overwhelm our body’s natural ability to remove them. That said, there are times when a balanced approach means we need to take a copper supplement. For example, if we take a higher than normal dose of zinc at the onset of a viral infection, it may have to be balanced with copper.
The Archives of Internal Medicine article also argued that folic acid use might shorten life. Nothing can be concluded from this source because the study is such a flagrant example of junk science. But the question about folic acid safety is a real one, and also an urgent one since federal law requires folic acid fortification of some foods such as bread.
Fortunately there is good medical research on the subject, albeit still inconclusive. A study published in February is very suggestive that only folic acid, and not natural folates, may be a risk for cancer. Natural folates, even at high levels, help to prevent cancers. This echoes two studies in 2009, reported upon by our ANH-Europe colleagues, which suggest that high doses of synthetic folic acid may produce an unexpected rise in some cancers, while natural folates are best for lowering the risk of colorectal cancer.
The main point to be gleaned from the research is that there is a potentially important difference between the synthetic folic acid and the natural folate. While awaiting more evidence, a rational response might be to use folate rather than folic acid.
It is not quite that simple, however. Merck has a patent on one of the natural forms of folate, which drives up the price. How, you might ask, can a drug company patent a natural vitamin? Welcome to the wacky world of government regulation.
2. Are there co-factors which must be taken with your supplement?
The Archives of Internal Medicine study mentioned above concluded that calcium was the one supplement that might lengthen life. This does not agree with better research. A large problem is that calcium needs to be taken with co-factors, especially vitamins D3 and K2. If these co-factors are not present, the calcium may migrate to the heart or circulatory system rather than to the bones where it is needed. If calcium is taken without supplemental magnesium, there may be other problems. That is why in an article last year, we criticized the World Health Organization for proposing that isolated calcium be put into the water supply. To do so would be more junk science—and could potentially harm a lot of people.
3. Do I trust the company selling it and am I taking the right amount?
These are interrelated questions since the company will advise you on the amount to take. Once again, in addition to seeking professional advice, you should do some research on your own. Start with the supplement company’s website. Contact the company. Ask whether the material is natural or synthetic, where it gets its raw materials, and what sort of testing regime it has. Some supplement companies test everything very carefully. Some don’t. Insist on getting answers about this. Good companies will be proud of their testing and will want to tell you about it.
Unfortunately, better quality supplements can be more expensive. That is another reason why we need to keep the FDA from driving supplement prices even higher, right up to drug levels, by requiring a new pre-approval process (see our Action Alert).
How else can ANH-USA help you sort through this important question of supplement safety? Let us know your thoughts and concerns and we will try to get you the answers.