Why supplements are useful

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I’ve noticed that a fair number of people in the paleo/low carb diet community have an aversion to supplements of almost any kind. The subtext behind this seems to be that if you have a decent diet and do all the other right things then supplements are in most cases not needed, just an extra expense, might give you too much of a good thing, and perhaps some other reasons.

For example, one advocate of ketogenic diets has said a number of times that getting exposure to sunshine is better than taking vitamin D supplements. There’s truth in this statement, since solar radiation appears (facts are not all in yet) to have other health benefits than simply stimulating the synthesis of vitamin D in the skin. The additional health effect of the sun is likely a hormetic effect, since getting out into the sun entails a significant amount of radiation exposure, which is proven to increase stress defense mechanisms. (As always with hormesis, the dose makes the benefit; high amounts of radiation are still unhealthy.) So, as I say, there’s truth here, but I’ll show below why following this advice – all sun, no vitamin D supplement – can leave you in worse health.

On Twitter, I recently pointed out a study that showed that n-acetylcysteine, the cheap and safe OTC supplement, may be useful in the prevention of atrial fibrillation. I was replied to by someone who noted another study that showed that adherence to a Mediterranean diet has positive effects on atrial fib, the suggestion being that you should eat your fruits and vegetables, drink wine and coffee, and prevent atrial fib, and skip the supplements. Sure, I agree that one should eat a healthy diet, but what if one already does so and still has atrial fib? In fact, I know someone (not me) where this is the case; eating more fruits and vegetables isn’t going to help this person.

Other are constantly pointing out things like the high magnesium content of nuts, or how eating fish is better than taking cod liver oil. That’s all great, but what of those who don’t eat much fish – and don’t like it much, like me – or don’t eat nuts?

Supplements can be quite useful and health-promoting. Getting back to vitamin D and sun exposure, what are you going to do in winter? How about if you live in northern latitudes? Except in the summer months, it’s nearly impossible to make vitamin D from the sun anywhere above the 37th parallel, that is, north of about San Francisco or Richmond, Virginia. Furthermore, even in times and places of abundant solar radiation, you have to be out in it with minimal clothing on to get much benefit; it goes without saying that most people work indoors all day and have difficulty getting solar exposure. Also, if you have dark skin, you’re going to need even more solar exposure to get enough vitamin D; one study found that a full one-third of NCAA athletes in Southern California, the land of sunshine, were deficient in vitamin D, and darker skin was a risk factor for this. These young people are presumably out in the sunshine a lot, yet many were still deficient.

Even using a minimal definition of vitamin D insufficiency, 42% of healthy adolescents were insufficient. This is another group that probably gets more sun than most people. Again using a broad definition of insufficiency, about 42% of U.S. adults are insufficient; this rises to 82% in African-Americans.

What about magnesium? As much as 57% of the American population is deficient in magnesium. It seems that most people use to get much of their magnesium from drinking hard water, but these days hard water for drinking is uncommon. Since magnesium deficiency is associated with obesity, diabetes, heart disease, and chronic fatigue, among other things, ensuring adequate magnesium intake looks pretty smart, and one can do that with a supplement.

The list can be multiplied. If you don’t eat fish much, there are fish oil supplements. Whey protein can raise levels of essential amino acids in the bloodstream much higher than can other food sources of protein, making it an important supplement for bodybuilders. Creatine: not much can be obtained in food, and supplementing helps build strength and muscle and even promotes longer life. The dose of resveratrol in a glass of wine is tiny, maybe 5 mg, so if you want to take this, a supplement gives a higher dose. Low-dose lithium increases lifespan in humans, and unless you’re one of the lucky people with naturally occurring lithium in your water, you won’t get any without a supplement. This is not a complete list by any means.

One other thing to emphasize is that you can be certain of doses with supplements. Not so with solar radiation, drinking water, or food.

So I hope I’ve given enough reasons why supplementing should not be dismissed, even if you have a healthy diet and lifestyle.

P.S.: If you found this post useful, you may want to read more about them in my book, Best Supplements for Men’s Health, Strength, and Virility.

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13 comments
MP Cato says December 15, 2014

I’m sold. But what supplements should a primarily-paleo 39-year-old man who’s recently begun strength training take? I already take high-dose fish oil, magnesium, a multivitamin, and hydrolyzed collagen, and I’m hoping that’s enough.

Reply
    P. D. Mangan says December 15, 2014

    I’m not at all familar with hydrolyzed collagen, though it sounds like it may be good post workout. Vitamin D has been shown to be important in athletics; there;s a lot of old Soviet/ East German research on that. I actually don’t advocate “high dose” fish oil, I’d go easy on it. Plenty of things I could tell you, I might suggest my book. It’s good value!

    Reply
      MP Cato says December 15, 2014

      Many thanks. I’ll look into Vitamin D and will pick up a copy of the book.

      Reply
Johnny Caustic says December 15, 2014

To your list of caveats about sun supplementation of Vitamin D, add the fact that the ability to produce Vitamin D in the skin seems to drop dramatically with age. I’ve heard it alleged that people over 50 can’t make enough Vitamin D any more, regardless of sun exposure.

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    P. D. Mangan says December 15, 2014

    Yes, don’t know about at all, but ability definitely declines a lot with age.

    Reply
Pete says December 15, 2014

Solid analysis. I think part of the problem is that the supplement industry as a whole is quite shady and full of snake oil. People are starting to wise up to the gimmicks, so this general negativity definitely bleeds into the small partition of the supplement industry that’s positive and legitimately useful.

Another problem is the natural fallacy. For some reason, especially in the vegetarian & paleo demographics, people often tout that “natural” (there’s never a clear definition of it, anyway) is necessarily better. Maybe this has gotten better in the recent past, but it’s one sentiment from these groups I just never could understand.

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    P. D. Mangan says December 15, 2014

    Thanks, Pete. I think part of the problem may be distinguishing supplements that we need, say magnesium, from other stuff that promises benefits but are of doubtful value.

    Reply
The Myth says December 15, 2014

If I remember correctly even precivilization peoples supplemented with special foods, herbs, and even minerals or special spring water. Animals do the same with eating feces and licking salt and mineral deposits or eating clay.

Not only does research support judicious use of supplements but it’s got a long, robust history. I’d be interested to hear your thoughts on lithium supplements. Paul Jaminet from Perfect Health Diet recommends them for depression. Very nice post.

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    P. D. Mangan says December 16, 2014

    Thanks. I wonder about lithium for depression. The dose that extends life is is maybe 1/50 to 1/100 the size (if I recall correctly) of the dose used in bipolar depression. So just off the top of my head I’m wondering whether it would work. In its favor, now that I think about it, there’s research showing lower rates of suicide with low-dose lithium in water, so it could work by reducing depression and suicidal impulses. Seems 5 mg lithium daily is worthwhile and safe – I’ve been taking that amount, though I need a resupply. Initial dose for bipolar, btw, is 1800 mg a day: http://www.drugs.com/dosage/lithium.html So low-dose lithium is really about 1/350 of that.

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      The Myth says December 16, 2014

      Yes I believe PHD’s recommendation was 2.5-5 mg per day of Lithium which is spot on with your math. I was thinking of dabbling with that for depression/anxiety/general mood.

      To Pete’s point – the supplement industry has caused their own problems. Much too scammy for my taste but again, the important ones that could actually be helpful like magnesium, vit D, vit K etc are not as glamorous so they don’t get the press they deserve. Kind of like lifting. Simple and straight forward tends to be the most beneficial for the majority of people but that won’t sell magazine or ad space, now will it?

      Reply
        P. D. Mangan says December 16, 2014

        That’s interesting about the supplements industry. I must say I’m out of touch with what the common man is exposed to re sups; whenever I see something questionable I just ignore it, without realizing that lots of men (and women) are not ignoring it and taking a lot of claims at face value. As you say, vitamins and minerals are not glamorous, they don’t promise instant weight loss or whatever else the weird class of supplements promise.

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Hi says January 21, 2015

What is your supplement taking regimen? Do you take them all in the morning? Are there any that should not be taken at the same time? Great website!

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    P. D. Mangan says January 21, 2015

    Thanks. I outline what I think should be taken in my book on supplements for men. I don’t take them all in the morning, magnesium for instance I take at night. Also see the recommended supplements page.

    Reply
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