Supplements are Unregulated Drugs

Published 10.17.2016
I've ranted about supplements previously, so I will try not to belabor the point. Supplement use is one of those topics that sets me off. So before beginning, let me re-iterate and emphasize: I am not a medical professional of any sort. The opinions presented here represent my personal experiences as well as my learning from scholarly papers or other sources. Nothing written here should be considered medical advice.

Supplementation should NEVER be necessary— at ANY age, contrary to what this women claims. If her diet was better balanced, she'd have no need to hork down handfuls of supplements. Supplementation is not necessary as you age either, unless prescribed by a real doctor— meaning an actual licensed, practicing MD. Supplements are drugs, and interact with the other drugs that too many elderly wind up taking.

There should be no reason to supplement if your diet is healthy. especially if you're eating a so-called "ancestral" or "paleo" diet. Or are we pretending now that great-grandma or paleolithic humans popped supplement pills? Hint: They didn't. You got what you needed from food. And if you don't overly restrict one macronutrient then your body will have all it needs to be healthy.

Real, whole foods in a decent variety is all you need to eat. Humans are not carnivores, and a meat only diet is not a healthy complete diet. Humans are not herbivores, some animal protein is necessary— unless you're going to supplement. Eat an egg a few times a week and a variety of grains, legume, vegetables and fruit and you are probably fine. Very little B12 is required, however, B12 is essential, and it's not found in any plant source.

Even vitamin D can be obtained from foods including beef liver, fatty fish such as salmon, cheese and egg yolks. Vitamin D is also produced by human skin interacting with sunlight. However, most people don't spend much time outside. As I've noted previously, a few months ago my doctor ordered me to start taking a daily vitamin D supplement, and that's what I've been doing.

Calcium is different

Calcium (Ca) supplements in contrast, should be avoided if at all possible— and it may be possible to avoid them if you are willing to alter your diet to ensure an adequate supply from diet. A recent observational study found an association between calcium supplement use and artery calcification. The study also compared the effect of Ca from food.

But the investigators found a potentially important difference in effect based on the calcium source. Calcium from supplements was associated with a 22% increase in the risk of CAC.

The issue is the excess Ca. Many foods (beans, greens, vegetables, etc) have calcium, plus if you eat dairy it’s not that hard to get what you need relatively quickly. then if you swallow a bolus of additional Ca, the body has to do something with the excess, and lining the coronary arteries with the stuff is one way to get it out of circulation. Forming kidney stones is another.

Here is a link to the actual text of the paper. The intake data was via diaries, so that’s a serious limitation, however, I think people remember whether they take supplements a bit better than what they eat because they do the same thing every day.

Calcium intake from FOOD was protective. As noted above, the problem is the bolus of Ca from the supplement that the body then needs to handle. And I bet many people are like me, in that they don't calculate how much Ca they are eating, but still add the supplements on top of whatever they’ve been eating.

To our knowledge, this is the first study that evaluated total dietary intake of calcium with progression of CAC scores in a large multiethnic population of men and women. After full adjustment for demographics, lifestyle factors, CVD risk factors, and use of calcium supplements, we found that among participants with a baseline CAC of zero, the highest calcium intake (≥1453 mg) compared to the lowest intake (<434 mg) was associated with a 27% decreased risk for incident CAC, suggesting a protective effect of total calcium intake in the highest consumers of overall calcium. However, when considering supplement use, the risk of developing incident CAC was 22% higher in those who used supplements than those who did not.

So to summarize: Ca supplements don’t help bones, but do hurt the heart. One final quote from the paper:

Rather than promoting bone health, excess calcium from the diet and supplements is postulated to accrue in vascular tissues. Pathological changes, presumably resulting from atheromas, initiate conversions of smooth muscle cells to bone‐forming cells or osteroblasts.43 Excessive calcium loading also has the potential to decrease parathyroid hormone (PTH) to suboptimal levels and thus increase the risk for adynamic or low bone turnover.44 To date, long‐term evidence that calcium loading from excessive dietary and supplement sources may accelerate pre‐existent arterial calcification has been lacking. CAC scoring is now recognized as a reliable biomarker of total atherosclerotic plaque burden and prognostic of risk for all‐cause mortality and coronary heart disease.19, 32

Supplements should be unnecessary, but definitely avoid calcium supplements!


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