Three Supplements You Should Avoid

I’m a big believer in targeted, but not indiscriminate, supplementation. Many supplements offer either a benefit next to impossible to obtain from diet (e.g. theanine) or give much higher quantities (e.g. resveratrol, vitamin D). (You can check out these and more on my supplements buying guide.) But there are a number of supplements that are associated with ill effects, yet are widely recommended either by doctors or mainstream health advice. Here are three supplements you should avoid.

Calcium

Calcium is widely prescribed for its alleged effect on osteoporosis, the thinning of bones with age. The first problem here is that it doesn’t work. A meta-analysis of studies on calcium intake and risk of hip or other bone fracture concluded that there was no benefit and possibly even increased risk:

Pooled results from randomized controlled trials show no reduction in hip fracture risk with calcium supplementation, and an increased risk is possible.(1)

Lack of calcium is not the cause of osteoporosis or hip fractures, it’s lack of weight-bearing exercise, dietary protein, and vitamins D and K.

Calcium is, however, implicated in coronary artery disease, since calcification of arteries is strongly involved. Calcium in the coronary arteries strongly predicts cardiovascular events, and in those without other known risk factors, it is in fact the strongest predictor.(2)

Calcium supplementation is associated with an increased risk of heart attack: a meta-analysis in the BMJ found that people allocated to a calcium supplement had about a 30% increased risk of heart attack compared to placebo.(3)

Calcium supplements (without coadministered vitamin D) are associated with an increased risk of myocardial infarction. As calcium supplements are widely used these modest increases in risk of cardiovascular disease might translate into a large burden of disease in the population. A reassessment of the role of calcium supplements in the management of osteoporosis is warranted.

Another study found more than double the risk of heart attack in users of calcium supplements.(4)

Use of calcium supplements along with dietary calcium intake > 1400 mg a day was associated with a 2.5-fold increased risk of death.(5)

For the love of God, don’t take calcium supplements.

An irony here is that increased consumption of dairy products, which contain lots of calcium, is associated with much lower death rates.(6) The reason, in my opinion, is that it’s not the calcium that’s protective, but something else, probably both protein and fat, or conceivably vitamin K.(7) Dairy products also inhibit iron absorption, which probably has a lot to do with their health benefits.

Clearly, the problem isn’t whether someone is getting enough calcium, but ensuring that the calcium goes to the right places: bones and not arteries. Vitamin K helps to ensure that calcium goes where it belongs, and higher intake is associated with greater bone mineral density.(8) Vitamin D is also much more helpful for bone density than calcium.

The tragedy here is that doctors routinely prescribe calcium supplements to older people, especially women, who are at greater risk of osteoporosis. Another reason why you have to educate yourself and not blindly follow doctors’ orders.

Iron

I’ve written about iron extensively, the upshot being that keeping iron levels in the low normal range is important for keeping yourself free of disease.

Some knowledgeable observers of iron and health believe that much of the problem of iron overload in the American population is driven by iron supplements, rather than diet.(9) Most multivitamins contain iron, and doctors widely prescribe iron to women, even when they’re post-menopause. Older people also get them for anemia, even when the cause is unlikely to be iron deficiency.

Iron overload from multiple blood transfusions is associated with much higher risk of death in sickle cell patients, on the order of 12 times higher.(10)

Iron overload is dangerous and begins at a level much lower than most doctors believe.

Don’t take iron supplements unless you have a demonstrated need and they are prescribed by a doctor.

Be aware of multivitamins that contain iron. For men over 20 years of age, and women over 50 who want to take a multivitamin, a “mature” multivitamin is a better bet, since these don’t contain iron.

Beware of iron-fortified foods, as this is equivalent to taking an iron supplement. Some breakfast cereals contain 100% of the daily requirement of iron, this being added to it – besides the fact that they’re made with iron-fortified flour or corn meal to begin with. (Anyway, you don’t eat breakfast cereal, right? that stuff isn’t even food, will spike your blood glucose and insulin, and make you fat.)

Don’t eat breakfast cereal, is my advice. Instead, fast, or eat some eggs.

Copper

Copper is a somewhat overlooked but required mineral. Not too many people knowingly take copper supplements, although it is found in multivitamins.

High levels of copper are associated with large increases in death from cancer, more than double the rate of people with low levels.(11)

Copper is also associated with increased risk of Alzheimer’s disease, atherosclerosis, and diabetes.(12) People in at the highest quintile of copper levels probably got there through taking copper supplements, either directly or inadvertently.

Copper, like iron, is a reactive metal, so it’s not surprising that high levels will do this. One of the few times that copper supplements may be needed is when high doses of zinc are taken, since zinc blocks copper absorption. In fact treatment for Wilson’s disease, or an overload of copper, is high-dose zinc. But for most people this isn’t necessary, as high-dose zinc for long periods of time isn’t a good idea.

Watch for copper in multivitamins. Again, mature multivitamins – some of them anyway – may be formulated without copper.

Conclusion: Metal Overload

Calcium, iron, and copper supplements are associated with health risks and should be avoided except under doctor’s orders. And even then, I’d be careful.

Is it any coincidence that all three of these are metals? I think it isn’t. Iron as a driver of aging may possibly be generalized to a metal overload theory – although we need them and can become deficient in them, too much is a bad thing. Of course, too much of anything can harm us, but we seem to be particularly susceptible to metal overload, since we have no regulated way of eliminating them from our bodies.

Since some of these supplements are added to things like multivitamins and foods like cereals, you should be aware of what you’re taking.

PS: See my recommended supplements for men in my book, Best Supplements for Men’s Health, Strength, and Virility.

PPS: You can support this site by purchasing through my Supplements Buying Guide for Men. No extra cost to you.

 

Subscribe and get my free book on fat loss

Leave a Comment:

39 comments
Nathan says January 31, 2016

Great info as usual. I keep reading as I always learn something new. I take a combo zinc / copper supplement (so as not to deplete copper levels) which has fixed a recently discovered low T level, but after reading I may alter it with a no copper zinc supplement every other day. Thanks

Reply
    P. D. Mangan says January 31, 2016

    I’ve read (source forgotten of course) that copper doesn’t need to be added to zinc supplementation unless zinc is 100 mg/d for a few months. So yeah, copper probably unnecessary with your zinc supplement. Cheers.

    Reply
      Rob H says February 2, 2016

      Hi Dennis, another very enlightening article! If you do happen upon the source you mention re not needing to supplement copper for zinc supps under 100mg/day, do please let us know.. I had just stocked up on a job-lot of 15mg chelated Zinc Bisglycinate (150% RDA) + 0.75mg Copper Bisglycinate (75% RDA) tablets a couple of weeks ago. I got a great deal on a year’s supply – but after reading your article I have returned them to the shop and exchanged them for straight Zinc Gluconate 15mg tablets instead. I’m thinking to take them once every 2 days (as opposed to daily), as I don’t appear to have any T issues currently (at least not that I am aware of) and don’t want to overdo the Zinc.. I’m figuring I probably get enough copper to offset the zinc from the sardines or mackerel I eat each day, plus 2 squares of 90% dark chocolate..

      In terms of supplements to avoid, I’d add one more metal: chromium picolinate which I read last can convert to the carcinogenic form of chromium in the gut: http://www.dailymail.co.uk/health/article-3394285/Could-weight-loss-supplements-cause-CANCER-Chromium-turns-carcinogenic-enters-body-s-cells.html

      Also, I personally avoid supplements containing pure ‘free radical scavenging’ anti-oxidants such as Vitamins E and C, and beta-carotene supplements (whether in natural or synthetic forms). Apparently the body responds immediately (to maintain homeostasis) by dropping levels of glutathione and other endogenous antioxidants by more than the amount of antioxidants taken exogenously, resulting in an overall net decrease in antioxidant activity. Very controversial though I know! Does anyone else have a view on that?

      Reply
        P. D. Mangan says February 2, 2016

        Hi Rob, vitamin C in gram amounts will do this. I don’t totally avoid vitamin C but never take it in large amounts. It appears that quite a few people are deficient in C (subclinical) so some can use it.

        Reply
        Joshua says February 3, 2016

        The article on chromium is interesting. Those of us who take IP6 (see the post a few weeks ago from this site) should take note especially. IP6 apparently chelates chromium pretty well (as per Herman’s comment on that article). I had been wondering if perhaps I should supplement chromium while taking IP6 for that reason. This article would suggest maybe that isn’t a great idea. (Fine by me, I’ll save some money by not picking up yet another supplement.)

        Reply
Rob sama says January 31, 2016

Supplement I take is 50mg zinc to 2mg copper. Would you suggest switching to a zinc only supplement? What is the recommended amount of zinc a man should be taking anyhow?

Reply
Allan Folz says January 31, 2016

Great timing as I have a supplement question for you and the gallery.

I just got a bottle of house-branch NAC from a major online discount-supplements retailer. It has a distinct “earthy, bung-hole” smell. This is my 2nd bottle of NAC. The former one was NOW brand and I don’t recall that smell.

Can anyone comment on how NAC should smell? Is this stuff old/spoiled/stored improperly?

It’s also entirely possible this is how NAC smells and NOW springs for better capsule packaging to keep the smell down. But I have no idea.

Thanks, Denis & all.

Reply
    Allan Folz says January 31, 2016

    I stand corrected. S.O. says the odor is rotten-eggs/sulfur. Question remains. Thx.

    Reply
    P. D. Mangan says January 31, 2016

    Hi Allan, that sulfur smell means the NAC has deteriorated. It shouldn’t have any smell. Store refrigerated.

    Added: For those wondering, n-acetylcysteine has a sulfur molecule attached. Cysteine and methionine are the two sulfur amino acids. When NAC detriorates, the sulfur detaches from the molecule, hence the sulfur smell from an old bottle of NAC that’s been exposed to air at room temp or higher. NAC should be kept in the frig because it deteriorates if at room temp long enough. How long – maybe months. If there’s no smell, it’s still good.

    Reply
      Allan Folz says January 31, 2016

      Thanks. Good to know. I’ll be sending it back.

      Reply
      Allan Folz says February 2, 2016

      Here’s what the vendor said when I contacted them:

      “According to our Proprietary Brands Department, the natural smell for N-Acetyl Cysteine is a sulfur-like odor, due to the high amount of sulfur in the amino acid cysteine. Unless it is a coated tablet, which this is not, there will be an odor.”

      Looks like it could be the capsule packing after all. Anyone know if NOW uses a coated capsule? Anyone with NOW NAC able to open a cap and let the contents sit in an enclosed container for 12-24 hours?

      Reply
        P. D. Mangan says February 2, 2016

        I just went to my container of NOW brand NAC, which I store in the frig, and opened it. If I let my imagination run wild, I might be able to smell something, but otherwise I’d say there’s no odor. I’ve smelled old NAC capsules before, and there’s a strong odor of sulfur.

        Reply
          Allan Folz says February 2, 2016

          Thanks Dennis, though the lack of sulfur odor could well be because NOW uses a coated capsule. I think you’d need to pull open a cap and smell-test the NAC itself, possibly also giving the small amount enough time to off-gas into an enclosed, container.

          Reply
Philomathean says January 31, 2016

How many times a week should vitamin k be ingested? I’ve was taking it everyday but I’ve started taking it every other day.

I also take 7500 UIs of vitamin D per day and I feel amazing.

Reply
    P. D. Mangan says January 31, 2016

    Probably every day isn’t strictly necessary. I take it almost every day myself, but the long half life makes it last longer.

    Reply
      Stephen Werner says February 1, 2016

      It should probably be noted that by “vitamin K” you mean vitamin K2, as opposed to vitamin K1, which has no effect on directing calcium towards incorporation into bone material rather than arterial plaques.

      Most readers undoubtedly are well aware of the difference, but neophites might make the mistake of thinking that “any old” vitamin k supplement will do the job.

      Reply
        P. D. Mangan says February 1, 2016

        Yes, that’s right, K2 is what does the job.

        Reply
Paul says February 1, 2016

This may be a crazy though but might a chronic bleeding hemorrhoid have an anti aging effect as to the reduction of Iron?

Reply
    P. D. Mangan says February 1, 2016

    Probably not as crazy as it sounds. That’s the same effect through which aspirin is thought to work.

    Reply
Oscar says February 1, 2016

Is there a multivitamin without those three? I’ve been looking all day and it seems that all of them (even “mature” ones) contain at least one.

Reply
    P. D. Mangan says February 1, 2016

    I don’t know the answer to that one, Oscar.

    Reply
    David says February 1, 2016

    I have yet to find a multi I actually like. Even if you get ones that don’t contain iron, most still contain Calcium (in high amounts), as well as too much Vitamin A, which I also think should be avoided supplementally based on multiple studies.

    Reply
Tuba says February 1, 2016

65yoa Male, fit, exercise seven days a week. Minerals are not easy. I’ve been low-carb/primal/paleo for a decade. I do not eat grains, sugar et cetera, do not eat out, and weigh all food consumed and log it. I know that is just an approximate but it is closer than guessing. My copper intake is 143% of the RDA, or 1.3mg. My zinc is only 62% of the RDA or 6.8mg. Thus I take 30mg of zinc a day to balance out the copper as one will lower the other. My iron intake is 171% of the RDA at 13.7mg with no fortified foods. My iron was 100 so I donated a pint a couple of weeks ago and will do so again in June. Calcium is a difficult call. I totally agree regarding don’t take supplements and all the problems related to cardiovascular disease. Dr. Jason Fung (you tube video) has a good argument that we really don’t need more than 400mg a day, don’t go over 800 and limit the dairy to one serving a day. On the flip side I am a sun advocate and think the only doctors more screw up than the nutritionists are the dermatologists. Most Americans (87% of dermatologists) are deficient in vitamin D and necessary for hundreds of body functions. I try to keep mine in the 60 to 80 ngml range, which at it’s lowest is twice as high as the deficiency level. Dr. Holick, arguably one of the world’s leading experts on Vit. D, recommends for someone my age 1200mg of calcium a day from all sources. I get around 800mg from all sources including full fat grass-fed dairy. I am, unintentionally, splitting the difference between the two of them. Holick avoids any discussing about K2 but I take 98mcg of that day in two doses to make sure the calcium goes the right place. To reduce the iron I dropped organic chicken liver now and then. The only way to drop the copper is to reduce the seafood which I upped to reduce the amount of red meat to occasional. It’s a tightrope all right.

Reply
David says February 1, 2016

Good article. It is amazing people still take Iron and Calcium given recent studies. I would strongly suggest adding Vitamin A to the list as well, based on a lot of evidence. I wrote about it a few years ago:

http://thepopularman.com/four-common-supplements-men-should-avoid-multi-vitamin/

Reply
Drifter says February 1, 2016

As far as I know, Calcium D-Glucarate is not absorbed as a form of calcium and has helpful properties, so you might want to consider adding that. Also, Paul Jaminet’s posts on copper note the interesting caveat that copper supplementation is only unnecessary assuming that you eat liver. Otherwise it is apparently fairly easy to be deficient. I haven’t looked into it but he cites some interesting links.

Reply
    P. D. Mangan says February 2, 2016

    I actually took copper supplements for awhile when I had CFS, though I no longer even remember why. The link I cited has lots of bad things to say about it and blames supplements for people being in the highest quintile of consumption, where most of the bad stuff happens. Not saying that paper is the last word, but I would have to have some solid evidence before supplementing.

    Reply
RW says February 7, 2016

So, after reading your book, Best Supplements etc., I ordered both a multi-vitamin (NOW Adam) and magnesium citrate. This was after using hydroxy citrate and niacinamide on fast days per your advice.

But the multi has copper, chromium and calcium, so I stopped taking it after reading your post here.

Additionally, I purchased some magnesium citrate, but it plays havoc with my GI tract. What about magnesium glycinate, which another reader mentioned?

Thanks for your input, RW

Reply
    P. D. Mangan says February 8, 2016

    Hi RW, bit of a run of bad luck there. Re magnesium, the glycinate form ought to be fine, since this is an amino acid chelate and should be highly absorbed from the gut. I wonder, were you taking a lot of Mg citrate at once? Normally the citrate form is fairly gut-friendly; Mg sulfate (Epsom salts) and milk of magnesia are used to get everything flowing.

    Re multivitamin, it might be best to just drop it. Finding one that satisfies all our requirements could be next to impossible.I take Mg, vit. D and K separately, occasional zinc and selenium, and as for the rest, I trust in my paleo diet to supply. The other supplements I take are not in multis.

    Reply
      RW says February 8, 2016

      P.D., the magnesium citrate dose was just 200 mg per day, but five days of magnesium and five days of the trots made me drop it. I already dropped the new multi, too.

      I’ll try the glycinate. I think I’ll also find a quality source of vitamin D.

      Cheers, RW

      Reply
caforager says February 9, 2016

Did you notice that the multivitamin that you linked to, the Kirkland signature Adults 50+ mature multi indeed contains no iron, but also contains 220mg of calcium as well as 45% RDA of copper? After noting in this article to NOT take calcium supplements or copper, why would I want to take this?

Reply
    P. D. Mangan says February 9, 2016

    Good point, no I didn’t even consider that. There are some multis without copper, that isn’t one of them obviously. It also seems that there are very few if any without calcium.

    Reply
Rob H says February 10, 2016

Hi Dennis, one more for the list for you of supplements to avoid, and I have to say this one was a bit of a surprise to me, since I have been taking this one myself everyday until now: fish oils. See link below:
http://chriskresser.com/when-it-comes-to-fish-oil-more-is-not-better/
Whilst they may be beneficial for folks following the standard American diet (very high in Omega-6), it seems that if you are eating oily fish (salmon, mackerel, sardines, herring) a few times a week, supplementary fish oils are not at all necessary, and in the higher amounts I was taking (more than 1 gram/ day), even potentially harmful. I’d even be wary of taking cod liver oil every day now (although I do eat oily fish almost every day). Both Chris Kresser and Chris Masterjohn only recommend cod liver oil as a ‘convenience food’ ie a good way of supplying the fat-soluble vitamins if you don’t obtain them from other good food sources. However, since I already eat a lot of egg yolks (4/ day on my 4 x non-fast days), pastured butter and supplement 2,000IU/ day Vitamin D3 during the winter, I’m figuring its probably best I avoid the Cod Liver oil too. The only caveat is that I don’t eat much liver (both Chris’s recommend that as the best source of retinol Vitamin A) since I know it contains an awful lot of iron: and I think avoiding excess iron trumps the positives of the Vitamin A content – which I can obtain from pastured butter and egg yolks. Just my thoughts anyway!

Reply
    P. D. Mangan says February 10, 2016

    Thanks, Rob, yes I was aware of not taking too much fish oil. I take 1 tsp cod liver oil, which contains about 1 g omega-3, about 2 to 3 times a week. I often hear of people taking massive amounts and always advise against that. It appears more important to get rid of omega-6, which I do. Anyway, I do treat CLO as a convenience food, since I don’t care for fish and I don’t take large amounts of the CLO.

    Reply
      Rob H says February 10, 2016

      Thanks for confirming that Dennis, I must have glossed over that when I was reading your books – sounds like you have got it spot on.. I had just been assuming that the more Omega-3 per day the better, but it wasn’t until today that I sat down and actually worked out that by having canned sardines or mackerel in olive oil each day for lunch, that provides between 2 and 3 grams of Omega 3 per day. So, no more Omega-3 required on top of that I think.. Actually, now I know how much Omega-3 they provide, I may instead just alternate them with a day of canned tuna (much lower in Omega 3s). Pretty much the only Omega-6s I consume are via nuts and seeds & eggs so I don’t need to compensate for a large amount of Omega-6. It’s a constant learning exercise isn’t it?!

      Reply
The Only 5 Supplements Scientifically Proven to Work - Rogue Health and Fitness says March 3, 2016

[…] (This is a guest post by Dan Fries, who writes on nootropics at his site Corpina. I believe that there are other supplements proven to work, as readers know, but hey, healthy disagreement. We’re also on the same page regarding supplements you should avoid.) […]

Reply
Kruegs says August 15, 2016

P.D.
Did I read somewhere on your site in supplements a recommendation on citruline? Im new to these things and I noticed calcium on the label and am either confused or mistaken. Please help my understanding.

Reply
    P. D. Mangan says August 15, 2016

    Hi Kruegs, yes I have a post here on citrulline: http://roguehealthandfitness.com/citrulline-treats-erectile-dysfunction/ Was calcium on the label of your citrulline, is that what you’re saying? I just had a look at my citrulline (Bulk Supplements brand), and no mention of calcium on the label.

    Reply
      Kruegs says August 15, 2016

      Thank you for the prompt reply. The now 750mg capsules have listed on the ingredient label:
      calcium from carbonate 36mg
      l. Citruline 1.5 g (1500mg)
      I’ll look into th bulk supplements product.
      Btw… I have read Best Supplements, muscle up and stop the clock. I really enjoyed them and reference them regularly.

      Reply
        P. D. Mangan says August 15, 2016

        I assume that calcium carbonate is some kind of mixer or pouring agent. 36 mg of calcium isn’t much. I’m glad you like the books.

        Reply
Add Your Reply