I need advice on vitamins and supplements.

July 6, 2009 2:04 PM

The vitamin/ supplement aisle of Whole Foods scares the hell out of me, I'd like some advice please!

Okay, so, you are not my nutritionist or doctor, but hopefully someone can help clear up a few things, or point me to something that does.

So I am deep in the throes of getting healthy (see prior question -http://ask.metafilter.com/122702/Help-a-vegetarian-lose-weight). I was at whole foods yesterday and stopped in their vitamin aisle, and was overwhelmed at all of the stuff that they sell, and my cynical self thinks “How much of this herbal/vitamin stuff is real, and how much is snake oil crap” and despite that I bought some flax oil, as I keep hearing about how great fish oil is, but I don’t eat fish, and I’ve been told that flax oil is a close second.

Also, I’ve been convinced that I should be taking creatine as I don’t get any, not eating meat and all. So I bought a bottle of that which seemed awfully expensive.

SO, what, you may ask, is my question. Here it is in 3 parts:

What is a well reasoned, legitimate resource that details the pluses and minuses of vitamins and supplements?

What supplements, herbal products, etc, from your experience, are useful/helpful?

What should a 37 year old, type A, vegetarian, trying to lose weight, and be healthier, be taking?

posted by Ponderance to health & fitness (29 comments total)

So, the PDR folks (the same people who make the Physician's Desk Reference guide to prescription drugs) also publish a guide to nutritional supplemens that I have consulted from time-to-time when patients have asked me similar questions.

I would also strongly recommend using PubMed and do some of your own research to look to see if there is evidence behind any of the supplements you are considering spending money on.

Long story short, from my perspective (allopathic/Western physician-scientist) ... if you are healthy, eat a healthy/balanced diet, then you should be fine and not need any supplements with the exception of iron (which you may be able to get from some legumes/nuts/eggs, and vitamin D (which you can get if you drink milk). The amount of benefit that you'll likely derive from supplements is minimal-to-none. There's certainly not a lot of quality scientific data to support the life-prolonging effects of flax oil or fish oil. That said, there is pretty good data showing that a Mediterranean diet (which can contain small yet regular amounts of fish, particularly oily fish high in omega-3 fatty acids) is good.

For weight loss, I'd save my money and instead follow the following inexpensive plan: take in fewer calories than you expend either by eating less or exercising more.
posted by scblackman at 2:18 PM on July 6 [1 favorite has favorites]

I've never heard creatine used in any other context then as a bodybuilding supplement - it's not a dietary requirement or anything that I've ever heard. (That's why it's so expensive!)

I'd recommend at least googling it before you start to take it - when used for bodybuilding/athletic enhancement, there's a moderately complex strategy for getting the best use out of it.
posted by restless_nomad at 2:23 PM on July 6

before i start recommending things, i just want to say that i understand the cynicism/skepticism. i was very skeptical of supplements and such before i started mine.

having said that, i take some supplements now to help with depression, and i find that they're helping a reasonable amount. they're much better than the anti-depressants i was on because they have no side effects, and i feel better knowing i'm not putting random chemicals into my body.

anyway, i just started taking fish oil 5 days ago, and i can already see that it's working. i don't have trouble falling asleep like i used to, i have more physical energy, and the dark circles under my eyes are clearing up (though that last one could be from a different supplement, i'm not sure).

this is the store i go to for my vitamins/supplements/dietary stuff. the site has a page called "Educate Me Now" with tons of good information on what you might want to try, what does what, etc. the store is awesome, the staff know their stuff, and i find the website a helpful tool too.

good luck!
posted by gursky at 2:23 PM on July 6

What makes you think that you need supplemental vitamins? That is, what problem are you trying to solve by taking these vitamins? If you have a specific need, you may want to supplement for that, but taking a bunch of pills just because you heard they're supposed to be good for you is likely to result in literally flushing your money down the toilet (your body will get rid of vitamins it doesn't need).

If you don't have reason to believe that you're deficient in some vitamin, I'd recommend a balanced diet, maybe a multivitamin, and a healthy dose of sunshine. You're more than likely just fine.

[I'm a vegetarian. I take a multivitamin and acidophilus (helps with occasional stomach trouble).]
posted by decathecting at 2:30 PM on July 6

You may find this article on the results of federal studies interesting. Short version: you have reason to be skeptical; ginger may help with chemotherapy nausea, and that's about it for supplements.
posted by 6550 at 2:34 PM on July 6

One rule of thumb: "natural" vitamins are the exact same thing as any other vitamins. It does not matter if your Vitamin C comes from rosehips, it's still just vitamin c.
posted by Juliet Banana at 2:39 PM on July 6

Flax oil isn't really a close second--you need huge, huge doses to get to the therapeutic levels of ALA that would mimic DHA and EPA in fish oil, and it's harder for the body to convert. (info) I don't know why you don't eat fish--ethical reasons or just taste?--but if there's ANY chance you'd consider a high-quality, well-sourced fish oil supplement that doesn't have a fishy aftertaste, I'd go for it.
posted by liketitanic at 2:46 PM on July 6

Read The Queen of Fats by Susan Allport. What matters is your omega-3 to omega-6 ratio because conversion of ALA to DHA requires the same enzymes and too much omega-6 means not enough ALA gets converted. Make sure your Flax oil is in a dark bottle and in the fridge because it oxidizes easily. Lastly, minimize omega-6 fats in your diet. It can be hard if you like olive oil and avocados, but it's worth it. My fat of choice now is coconut because it doesn't mess up the balance.
posted by melissam at 2:50 PM on July 6

One rule of thumb: "natural" vitamins are the exact same thing as any other vitamins. It does not matter if your Vitamin C comes from rosehips, it's still just vitamin c.

I read that vitamins from fruit and vegetables were more easy for the body to take up than pure vitamin pills. Is this wrong?
posted by devnull at 2:51 PM on July 6

Also, make sure the eggs you get are from truly free-range chickens. Even if you have to visit them....good eggs are worth it! Often the ones labeled as free range at Whole Foods are from chickens that technically have access to the outside, but don't spend much time there. I visited a farm and met the chickens to get my supply. Same goes for dairy. You only really get the health benefits from these foods if you are eating the good stuff.
posted by melissam at 2:52 PM on July 6

This is such a matter of "who do you trust?" I wouldn't know which direction to send you for good information because it's all so skewed depending on where the purveyor of said information is coming from.

Honestly, I'm of two minds on the whole supplement thing. On one hand, I know the power of Big Pharma and their ability to fund studies to show negative results, slip briefcases full of cash to so-called "independent studies", (use your imagination) -- to preserve their multi-billion dollar industry based on illness and greed. They are ruthless and I put nothing past them. On the other hand, I worry about vitamin supplements and their lack of regulation, especially with so many groups saying that vitamin supplements often don't even contain what they're supposed to - or at the least, have differing amounts of the ingredient from what is stated on the bottle. It's all confusing and I share in your frustration. I often wonder if just the right combination of this or that would make me feel better; but in the end I stick with a good multi-vitamin with extra Vitamin C and call it a day.
posted by Gerard Sorme at 3:03 PM on July 6

I read that vitamins from fruit and vegetables were more easy for the body to take up than pure vitamin pills. Is this wrong?

Devnull, are you talking about eating an orange versus taking a vitamin C pill? Of course it's better to eat the orange. You get fiber and freshness and oranges taste awesome.

However, ascorbic acid is ascorbic acid, and if you're taking a pill, there is no difference between hippy fruits and vegetable vitamins and drug store vitamins.
posted by Juliet Banana at 3:08 PM on July 6

Sometimes there's a difference between hippy fruits and vegetable vitamins and drug store vitamins. Vitamin E for instance, describes a family comprising 8 distinct chemicals. You'll often hear a recommendation of natural Vitamin E over synthetic Vitamin E because the former, d-alpha tocopherol, has better bioavailability than the latter, dl-alpha tocopherol.
posted by Zed at 3:34 PM on July 6

(wow, what a totally useless article that was. No links to the studies at all- it appears to be a rant about taxpayer's money more than anything.)

Anyway: OP, why are you taking these supplements? A healthy vegetarian diet should be fine for everything but possibly iron, but you can cook in cast iron and make a point of eating high-iron foods. Eat a wide variety of foods (vegetables, fruits, nuts, grains, dairy) and you don't need to visit the vitamin aisle. So to answer your last part, I wouldn't take anything, unless you and your doctor find there's something you're not getting from your diet.
posted by oneirodynia at 3:38 PM on July 6

After two years of medical school, the only supplement I take is vitamin D. Most people spend all their days inside and don't get enough of it (and if you don't eat fish you're especially at risk). Deficiency can increase your chances of bone fractures and maybe possibly lots of other stuff. Since it's a fat soluble vitamin (unlike say vitamin C) it is possible to get too much of it, so you should maybe supplement with smaller doses and/or consult your doctor for a blood test.
posted by genmonster at 3:49 PM on July 6

Vitamin D is legit, especially during the winter, the health benefits to it have a bit more evidence than for most vitamins and a large percentage of people who live far from the equator and/or are dark-skinned have vitamin D deficiency. You can get your levels checked at your next doctor's appointment if you think you're at risk of deficiency.

Creatine as a supplement can have side effects (dehydration and leg pain), if you're not bodybuilding there's no real reason to be on it, it may do you more harm than good.
posted by phoenixy at 3:52 PM on July 6

You don't need supplements.
posted by OmieWise at 3:55 PM on July 6

1. I am a fan of Ann Louise Gittleman, Earl Mindell's Vitamin Bible, and The Fit for Life Diet.

2. I use GROUND flax seeds, Maca, and GNC Ultra-Mega-Stress vitamins.

3. IANYN, but I wish I was a licensed nutritionist/dietitian and am planning on going back to school and get that Certificate!

From my own research and trial and error, I have found ground flax seeds to be miraculous. Yes, that's right - I said it - MIRACULOUS. And there is a HUGE difference between whole flax seeds, ground flax seeds and flax seed oil capsules.

True Story: I've had something "not right" with me for some time now and no meds I ever got from the doctor over a one and a half year period worked, but within 2 weeks of adding 2 teaspoons of GROUND flax seeds to a glass of OJ to my diet - Poof and Presto... 98% back to normal.

I am all for supplementing your diet with vitamins and minerals.
posted by goml at 4:01 PM on July 6

Gerard Sorme - you do know that in most cases Big Pharma and Big Vitamin are the same companies? This is not new. Geritol, the old hand of multivitamins, is currently produced by GlaxoSmithKline. There are some independent companies, but the majority of the market is (I believe) in the hands of multinationals who also have pharmaceutical interests. They don't give a toss whether your health paranoia leads you to buy their drugs or buy their vitamins, as long as you buy.

Another medical student, and generally you need no supplements. Exceptions:
- B12 if you're vegan
- Vitamin D if it's dark or you're inside a lot
- Folic acid if you're pregnant or want to be

Essential Fatty Acids - from a dietitian I trust, the evidence seems to be equivocal. They may be worth trying if you have mental health problems, ADHD or autism. But I stress 'may be'. They also need to be taken at significantly high doses (most of the trials have high doses), which will almost certainly bugger up your weight loss programme. And they should never be taken if you're on anti-coagulants like warfarin.
posted by Coobeastie at 4:17 PM on July 6

Edit: 2 TABLEspoons not teaspoons.
posted by goml at 4:28 PM on July 6

Oh yes, and for the people above talking about the health benefits - they might actually increase, not decrease your risk of dying of cancer: "Although the jury is still out on the benefits of vitamin supplements, this research raises the possibility that they could actually cause harm in the long term."

Though others have just found they do bugger all.

Ground flax seed is great for constipation. It's amazing what improved bowel habits can do for your general sense of wellbeing.

And your body can only absorb so much of certain vitamins at a time. Megavitamins are generally good for giving you really expensive urine.
posted by Coobeastie at 4:29 PM on July 6

I disagree with responses suggesting you get what you need from your diet alone (regardless of vegetarianism). Why? Not because I don't believe you can, but for the fact that almost no one has any idea what nutrients they consume regularly. Therefore, you can't know which ones you need more of. If you knew these things, you could tailor your diet to meet your needs.

Trying to figure out supplements for individual nutrients without knowing what you even need seems like nothing more than pure speculation.

If you just want some insurance, pick up a high-quality, broad vitamin/mineral supplement, eat a varied diet focused mostly on plants, and hope for the best.

But if you mean to get serious, get ready to do some work. You need need to begin tracking your food consumption and actually figuring out what nutrients you consume and which ones you lack.

I know of one excellent, free software program that allows daily food tracking and that shows comprehensive nutrient data. It links to the USDA database and calculates consumption of nutrients based on the quantity and type of food you input in your daily food journal. The software is Cron-O-Meter. Originally devised to help people who practice rather strict calorie restriction for longevity purposes (where they still want to ensure 100% nutrition), it works brilliantly for anyone who just wants to know how their diet performs. I think Fitday offers similar functionality, with the benefit that you use it on the web, so you can "take it with you" when away from home.

Armed with data from software, you can then visit this excellent website to find out what foodstuffs satisfy your missing nutrients.

That may seem like a lot of work. But short of tracking what you take in and reviewing the nutrient profile of your diet, you will simply stab at the dark trying to figure out what supplements you might need.

No one on this website, nor your doctor--nor even a dietitian or nutritionist--can tell you what you need if you don't know what you take in already.

Having said all that, it seems pretty likely that many, many people become Vitamin D deficient. It does not occur naturally in ANY food except certain fish, fortified dairy, and eggs. 4oz of salmon contain 107%, an egg just 5.7. Unless you get a LOT of sun over a large part of your body on a regular basis, you probably don't get enough. Studies increasingly demonstrates this. Dairy products enriched with Vitamin D help in exactly the way a pill does.
posted by ViolaGrinder at 4:45 PM on July 6 [1 favorite has favorites]

It's too bad the Natural Medicines Comprehensive Database is behind a paywall; it's an excellent resource. You might try to find out if you can get access via a local library, college, or other organization.

The University of Maryland Medical Center has a nice online searchable resource, and the Mayo Clinic has some nice articles in their site as well.
posted by gimonca at 4:52 PM on July 6

I know the power of Big Pharma and their ability to fund studies to show negative results, slip briefcases full of cash to so-called "independent studies", (use your imagination) -- to preserve their multi-billion dollar industry based on illness and greed.

This. Is. Delusional. Point me to any evidence of this ever happening. These are companies like any other, and if you insist on a default position of cynicism, the rival conspiracy theory of all this vitamin lore having been made up the pharmaceutical industry makes much more sense.

True Story: I've had something "not right" with me for some time now and no meds I ever got from the doctor over a one and a half year period worked, but within 2 weeks of adding 2 teaspoons of GROUND flax seeds to a glass of OJ to my diet - Poof and Presto... 98% back to normal.

See, the evidence-based medical response to such reports would be to gather a large group of people and do a double blind study of whether this has beneficial effects (even if they're self-reported). So if this isn't presently recommended by medical community, you can choose from one of several explanations:

1) They aren't studying it through some irrational bias against it. I find this hard to believe considering how competitive the industry is and how much money/fame/support they would earn by making such a discovery.

2) They are studying it, but are either rigging or suppressing the results. Again, why? A common trope I've heard is that they want to make more money with their "chemical" (as if some substances were more "chemical" than others!) antidepressents. This is implausible when you take in to account how expensive it is to manufacture those compared to simply growing/bottling some flax seeds. Not to mention, a more effective drug would let you move way more product to a much larger audience, and without the torturous hassles of drug regulation (because it's a "supplement" to the FDA).

3) It doesn't work, and your shift from "not right" and "right", while very real, was not precipitated by the flaxseeds, except perhaps in the sense that taking action, even if ineffectual, positively effected your attitude. While there may be no harm in taking them, you should be more cautious about recommending the practice to others in humble acknowledgment of the limited nature of one person's highly subjective experiences and the assumptions that need to be made (see preceding) to reconcile them with the reports of experts.
posted by phrontist at 5:06 PM on July 6 [2 favorites has favorites]

Coobeastie - That's not quite right. Big Pharma does not own/manufacture most of the vitamins and mineral supplements. Maybe the drug store Geritol stuff, but the big names in the industry are owned by companies like Nutraceutical, which has some of the biggest brands in the business - Solaray®, KAL®, Nature's Life®, Natural Balance®, NaturalMax®, VegLife®, Premier One®, Pioneer®, Sunny Green®, Zand®, Natra-Bio®, bioAllers®, Herbs for Kids®, NaturalCare®, Natural Sport®. (From their website.)

The big business in this industry is not the One-A-Day type vitamins you see at Walgreens (those are dominated by big health & beauty corporations - not all Big Pharma). The big business is through Internet sales, health food stores which include some big chains, they also sell through the Walgreen's, CVS, etc. These independent brands are always at odds with Big Pharma. Some may be affiliated - most are not.
posted by Gerard Sorme at 5:10 PM on July 6

It isn't clear that vitamins (supplements) are good for you.
posted by rr at 8:48 PM on July 6

I hope all this has cleared things up for you. ;-)

You have stepped into a quagmire of studies, counter studies, quasi-science and outright myth. The plain fact is that in many cases we simply do not know the truth, so what it's best to do is try what seems plausible to you and isn't too expensive.

If you are eating reasonably well you probably don't need anything at all. To be on the safe side, I'd take a daily multi-vitamin and omega-3s. Even though there is a chance they are useless, the cost is low.
posted by dzot at 6:03 AM on July 7

Thanks everyone this is a fantastic set of answers!
posted by Ponderance at 7:56 AM on July 7

Creatine is actually pretty cheap. I think the key here is to order in online. Whenever I walk into a vitamin/supplement store and ask for creatine, the salesperson wants to sell me an outrageously priced capsule. Creatine monohydrate is extremely inexpensive (at $12.95 for 100 servings). There aren't many supplements that cheap.

Although the stereotype is that only bodybuilders use it, it's used by all kinds of athletes. An interesting article here (okay, this one is directed at bodybuilders, but it's still interesting). If you're not terribly active or don't have goals that are athletic in nature, it may not really be that important for you to take.
posted by Barry B. Palindromer at 1:07 PM on July 7