Navigating Supplement Selection

Supplement Education
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Unveiling the Best Choices for Your Health Needs

Sitting at dinner recently, I mentioned to my wife, Tracey, that I was working on my next article for Cityview. “Why are you writing another article? Don’t you already have enough on your plate?” Her reply caught me off guard, but Tracey always calls them like she seems them and she is always concerned that I work too much. It made me pause and really think, “Why am I writing this?”

The real answer is that nutrition, exercise, and supplements are common topics that I discuss with my orthopedic patients. In fact, I encourage (if not insist) that all of my patients prepare for surgery with a plan that will find them as healthy as possible on the big day. I’ve spent quite a bit of time learning about how to go about it and the impact it will have on the body, not just for my patients, but for myself. So, as Cityview’s newest writer, it seemed important to share some of this information with readers. What’s good for the goose is good for the gander, as they say, and it is my hope you find something here that makes you feel a little—or a lot—better.

The World of Supplements

Have you ever been into a health food store and just been overwhelmed by the sheer volume of supplements? Even a stroll down the vitamin aisle at the grocery store can be daunting. Various commercials and podcasts will espouse their product as “the one you can’t live without”. It is hard to tease apart the bias from the scientific data. So, I decided to catch up with Eddie Raymond at a local watering hole to seek some truth. Eddie is originally from Switzerland and as all Swiss do, he joined the military. It was there that he cultivated self-discipline and an interest in nutrition and health. As an entrepreneur, he rolled this passion into a business 23 years ago which is now known by most simply as Eddie’s Health Shop. It has become a Knoxville “go to” for supplements and advice. So, when asked about the best supplements that the average Joe should take, Eddie said something that I very much also believe: “It all starts with nutrition, exercise, and self-discipline.” Supplements are just that, an addition which can help one’s health. They cannot ameliorate the effects of poor nutrition or lack of exercise, thou. With that said, let’s explore some supplements for the benefit of all.

The Multivitamin

Leading the pack was a good multivitamin, but what makes a good one? Those derived from whole food with good fillers. Specifics include methylated folate (B9) and methylated cobalamin (B12) which are the active forms. The importance of multivitamins increases with age and with pregnancy. However, multivitamins are not as necessary if your diet is rich in polyphenols found in colorful fruits and vegetables (incredible source of antioxidants) and nuts which are chocked full of B complex vitamins, magnesium, copper, zinc and selenium.

Vitamin D

Roughly 70% of Americans are deficient in vitamin D. Vit D is a pre pro hormone, meaning that it has to undergo modifications termed hydroxylation’s in the liver and kidney to become the active form useful in your body. If your diet contains abundant amounts of cod liver oil, salmon or trout, then you might not need supplementation. However, since most of us are not consuming those foods on a daily basis, supplementation could be considered.

The number one way to increase your Vit D levels is 30 minutes of sun exposure. In mammals the naturally occurring cholesterol in the skin is converted to Vit D by UVB light. UVB is blocked by glass so direct out door exposure is the only way to get it. As we have become more industrialized and office based, we have lost much of the solar exposure. Most people are familiar with Vit D and its effects on bone health. There is a beautiful homeostasis (body’s maintenance of the status quo) between Vit D, calcium, phosphorus and parathyroid hormone to remodel our bones. About 5-20% of our bone mass is remodeled each year.

Vit D, is also critical for muscle function, glucose and insulin control and immune function. Vit D receptors are found on nearly all the cells necessary for proper immune function to include T cells, B cells, and antigen presenting cells which affects the ability to defend ourselves from viruses, bacteria, and also cancer. Although the recommendations vary, adults should supplement with 2000 IUs of Vit D3 daily.

Omega 3s

Like Vit D, Omega 3s are found in fatty fish like salmon but also egg yolks and almonds. Omega 3s are naturally made by microalgae which are consumed by phytoplankton and krill and then other fish with the concentration of Omega 3s increasing up the food chain. The two most important ones are DHA (Docosahexaenoic acid) and EPA (Eicosapentaenoic acid). They are found in high concentrations in the structural cell membranes especially in the brain.

Omega 3s can reduce inflammation by competitively inhibiting the metabolism of the more common Omega 6s. The metabolites of the Omega 6s are prostaglandins which are proinflammatory. NSAID’s are medications that inhibit this prostaglandin formation however through diet and supplementation, you can reduce systemic inflammation. Omega 3s have also been shown to reduce triglyceride levels. Look for high levels of DHA and EPA around 800 milligrams or higher. Eddie did say that there are liquid emulsions that are more bioavailable than the gel caps and are actually quite palatable.

Magnesium

Magnesium has gained more attention recently as common supplement as it is required for the hydroxylation of Vit D to its active form. Very few things in the body exist in isolation. Meaning that levels of one mineral or vitamin affect another. The same is true with magnesium and Vit D. So much so that studies on high dose magnesium and Vit D in COVID patients has yielded encouraging results. Magnesium is also important in the mitochondria specifically in the electron transport chain which converts fatty acids and glucose into ATP (adenosine triphosphate). ATP is the energy currency of the body.

There are many different magnesium sources out there. The most common is magnesium oxide which has poor bioavailability so should probably be avoided. Magnesium threonate crosses the blood brain barrier and is therefore promoted for brain health and sleep. I personally take magnesium threonate and L-theanine at night for sleep. Other forms include malate, citrate, glycinate which are all fairly well tolerated although higher doses are associated with diarrhea. Two hundred to 400 milligrams should be sufficient for supplementation.

Probiotics

Finally Eddie suggested a probiotic to round out the list. The way that I like to think about gut health is prebiotic, probiotic, and postbiotic. I’m a simple person so categorizing the actions surrounding gut health makes sense to me. Prebiotic food stuffs are things like soluble fiber and polyphenols. These are the foods that your gut biome (bacteria in your gut) ferment and turn into short chain fatty acids, which are absorbed by the body and also used locally to nourish the endothelia cells that line our gut. Probiotics are bacteria that you can ingest in powder or capsule form to help maintain a healthy number of bacteria in your gut. Postbiotics are the actual short chain fatty acids themselves with some bacteria. These come in the form of Kambucha, Kimchi, kifir, and kvass. Many cultures have some form of fermented drink so there must be something to it—but you have to develop a taste for it.

Other Supplements Not to Miss

The above supplements will cover you for improving your healthspan—and possibly lifespan—but what about specific circumstances like a desire to increase muscle mass, exercise recovery, high blood pressure, or blood glucose control?

For increasing lean muscle mass, Eddie recommends a good whey protein isolate. Adding casein to this will increase the length of time over which you will digest the protein.

Creatine is probably the most studied supplement. It is simply a fuel source in the cell. Creatine is a natural peptide made by your liver from the amino acids methionine, arginine and glycine. It is then phosphorylated so that it can be used as an immediate fuel source. It is burned up within several seconds and then the body turns to glucose stores for more energy. Eighty to ninety percent of your creatine is in your muscles with the rest of it in your brain. Unless you have significant kidney disease, it is a safe energy supplement.

Lets switch gears from muscle building to blood pressure and glucose control which affects most Americans over the age of 50. I started noticing a slight but steady increase in my blood pressure so I added beet root crystals to the daily regimen. I noticed a 10 point decrease in the systolic and diastolic numbers. The reason is the increase in nitric oxide that dilates your blood vessels. Other supplements like citrulline and arginine are also on this similar nitric oxide boosting pathway, but I prefer something whole food if possible.

Finally alpha lipoic acid is a supplement that has been shown to decrease insulin resistance by increasing uptake within skeletal muscle. It is most commonly used in patients with diabetic neuropathy with positive results.

Pulling it All Together

Improving your health span and life span starts with good baseline nutrition and routine exercise. Supplements can enhance the body’s ability to burn energy and recover and even mentation. There are many that have positive effects for most of us and a few that you can choose for specific goals. Always ask your health care provider before starting supplements to see if they are right for you.  

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