Supplements worth the money

In an industry full of promises, what actually delivers.

The dialysis catheter removed, and I need to manage my damaged kidney filtration on my own.

Aw the world of supplements… it’s an unwieldy maze of snake-oil and big claims, not covered by insurance. How do we sort fact from fiction?

Greetings Lovely RDG Readers!

I’ve taken all kinds of supplements in my life, from pretty ones sold on podcasts that made me burp to strange tasting ones from acupuncturists.

Prices have varied wildly.

But after kidney damage, I have to be more protective about what I make my body process. I need all the bang for my buck.

So here’s a little of what I’ve found of the major supplements that are worth taking because studies support their effectiveness. Now, more data may come to support claims, but without clinical trials - we work with what we can.

My Supplement Breakdown

Always consult your doctors about things you read on the internet from ladies without a medical degree, but here’s what I’ve found:

The Winners

VITAMIN D

Ah, the sunshine vitamin. It’s actually pretty tough, unless you work in the sun, to get all you need through your skin. Vitamin D helps us absorb calcium. I used to be vitamin D deficient (and honestly doing this research reminds me I need to get on this). Most adults can’t eat or get sun exposure enough in modern life to satisfy the daily need. So it’s a good idea to get a vitamin D supplement according to Harvard health, “Current guidelines call for 600 IU (international units) a day below age 71 and 800 IU a day thereafter. But many experts recommend 800 to 1,000 IU a day for most adults; daily doses up to 4,000 IU are considered safe, but more can be toxic…”

Apparently taking too much has a lot of risks, including serious ones like kidney failure and irregular heartbeat. Vitamin D supplements can also have problematic interactions with certain common prescription medications, including statins.

Harvard Health says “The form known as vitamin D₃ is usually recommended, but D₂ is also effective; for best results, take your vitamin D along with a meal that has some fat.”

When in doubt, take a blood test like I did and see if you are deficient. I recall it really improved my mood and energy. I should get back on this one.

B12

Vitamin B12 helps with nerve function and in our DNA, plus it’s been shown to have a correlation to dementia if you have a deficiency. As we age, sometimes a supplement is helpful because our bodies don’t absorb it as well. It is especially a good choice for vegetarians, since it’s found more readily in meat and dairy. It’s added often to grains, but if you’re not eating a ton of meat or fortified foods it’s a good choice. Young folks may not need it as much yet if they get enough through diet.

The Losers

Antioxidants. Vitamin E, vitamin A, beta carotene, zinc and vitamin C and more

According to Harvard Health’s Supplement Scorecard these supplements don’t support their claims and can often be dangerous. “In fact, even moderately high doses of vitamin A increase the risk of hip fractures, and high levels of vitamin A have been linked to an increased risk of prostate cancer; beta carotene increases lung cancer risk in smokers; and vitamin E increases the risk of prostate cancer and has been linked to an increase in respiratory infections, heart failure, and the overall death rate. Do not take antioxidant supplements.”

They do concede one exception: people with moderate or advanced age-related macular degeneration (AMD) benefit from special antioxidant supplements that also contain zinc. But it doesn’t prevent AMD in people who have healthy eyes.

I can hear my husband Zach asking, “But wait, what about zinc for colds?”

According the Mayo Clinic, “There is no guarantee that zinc will help you feel better faster. In some studies, zinc did nothing to shorten how long people with colds felt bad. In other studies, zinc may have shortened symptoms by a few days. But the side effects from taking zinc can be uncomfortable or serious in some cases.”

Side effects commonly associated include a weird mouth irritation (this one always gets me) and bad taste or upset stomach.

They go on to explain, “Researchers can't say why zinc works in some studies and not others. There are still questions about which type of zinc works best. Research also doesn't show what amount of zinc is the best.”

Multivitamins

I was once told you just pee most of the vitamins away and you should just take the vitamins you need specifically. Like if you need vitamin D, get vitamin D. You don’t need the extra. Experts generally say to skip them. Harvard Health says,"there is no evidence that multivitamins enhance health and well-being or prevent illness.”

And they aren’t alone US Preventative Service Task Force aligns with that conclusion.

However there are a few who say it might correlate to a lower risk of cancer or cognitive aging.

But if you have a choice of options and you’re on a budget, experts are not overwhelmingly convinced.

The Honorable Mentions

Folate

Folate plays a role in red blood cell production and DNA building among other vital tasks. There’s lots of folate in food, but it’s easy not to get enough. People who are pregnant or trying to get pregnant should definitely be taking folate. Folate fortification has eased birth defects.

Fish Oil

So here’s the deal on this according to Harvard Health - if you eat fish twice a week you likely don’t need fish oil. “For years, doctors have known that people who eat fish regularly enjoy some protection against heart disease and stroke.” But if you’re not getting fish in your diet, it could help.

Or maybe just eat fish.

Fiber

We’ve all heard we need our fiber. Especially to keep us “regular” in the digestive sense. And it’s true. Fiber helps avoid conditions like diverticulitis and hernias, but also helps with heart disease. But the best way to get fiber in our bodies is through our foods like whole grains, fruits, veggies, nuts and seeds. If you’re making a shift to more fiber, go easy at first - or your tummy might be a tad grumpy and you might find yourself rushing to the bathroom.

Magnesium

Magnesium is a mineral that is super beneficial for the body with a ton of benefits from better sleep, reduced migraines, improved mood and blood pressure. But yet again, the best way to get this may be through healthy diet. Magnesium is found through nutrient dense foods that are win wins. So instead of reaching immediately for a supplement, start with the grocery list: avocados, nuts, beans, seeds, fatty fish, bananas, and leafy greens. Also dark chocolate! Bonus!

About 9% -17% of adults studied have a deficiency - so if you’re in that crew, a supplement could help.

Calcium

Calcium is classically important for bone health and other vital functions. Not everyone needs a calcium supplement, but it likely helps post-menopausal women. As women age, we don’t absorb calcium from food at the same rate. Especially if lactose intolerance develops later in life. So this one is a good one to talk to your doctors about when the time is right.

Probiotics

The jury is still out on probiotics. The potential is huge, but there’s a need for more clarity. And lord knows, I’ve bought PRICEY probiotics. According to the Mayo Clinic, “There is no clear evidence that probiotics are beneficial. While many small studies have been conducted, there has been no standardized way to study probiotics and their effects, making it difficult to compare the results of different studies. Probiotics are not regulated by the Food and Drug Administration, which means the companies that make probiotics do not need to prove the product contains the ingredients listed on the bottle.”

The Cleveland Clinic says probiotics are very much under active research, so hopefully we’ll get more information soon. The possible benefits could be super helpful to our microbiomes. Don’t throw out your yogurt or kombucha just yet, but maybe don’t spend $100 on a specialty probiotic developed by some guru on the internet.

Keep your eye on the probiotics space, because hopefully we’ll know more soon. Here’s the NIH Fact Sheet on Probiotics that is pretty up to date on studies.

Reminders:

• Watch the dosage. More does not mean more benefit. More means increased side effects and risks.

• Work with your doctors. They have insight you don’t. There may be a reason to avoid a particular supplement for your specific health situation.

• If a product comes with big promises, be wary.

• Beware of drug interactions- always tell your doctors what supplements you’re taking.

• Hidden active ingredients can be big trouble, especially in supplements that tout weightloss and sexual enhancement. “The FDA recently tested nearly 70 of these products found on Amazon, eBay, and Walmart.com, and discovered most of them contained active pharmaceutical ingredients not listed on the label. These hidden ingredients may interact with other drugs you are taking, or they may be associated with serious side effects. All 29 of the products the FDA purchased on Amazon, 80% purchased on eBay, and half of the products purchased on Walmart contained undeclared active pharmaceutical ingredients,” according to the FDA.

• And while supplements are wildly unregulated, there are some private companies trying to sift through the madness. Check for United States Pharmacopeia (USP) or NSF International seal of approval.

The moral of the story might be lean on a healthy diet and use supplements to simply supplement what you might not be able get easily on your own.

I know there are many good supplement companies trying to do things above board, but it can be hard to sift through what’s what. So just watch your budget and research the source.

And as always, I’d love to hear from you all. Feel free to drop your knowledge and wisdom in the comments. If you have info, bonus points for including a source for folks to read up.

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COMMENT OF THE WEEK

“Yes! Media literacy is so important! Thank you for all the helpful tips on how to navigate researching a diagnosis.” Kristen

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If you’re new here and wondering, “what happened to this lady?” read:

I started writing this when I was on dialysis. It’s intended to be both memoir and a practical tool to help folks who might be going through something similar or those caregivers and family supporting someone with a challenging diagnosis. NOTE: This is not intended to replace actual medical guidance. Please consult your doctors on your individual challenges and situations. Please talk to your clinicians before adjusting any of your care protocols. Also names have been changed for most of my medical staff.

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