What do I really need to take?

I am frequently asked about supplements: What vitamins should I take? What about other supplements? So, I thought it would be great to talk about supplements in this week’s post. What are the essential supplements we should take and what is the data behind them?

I will tell you the top three supplements I think everyone should take (and I take myself), but depending on your particular situation or health concerns, you may benefit from taking one or two additional supplements. That being said, I am not at all pro taking 1,000 supplements daily and for the most part I believe in the “less is more” approach.

I would also like to mention that it is important that you take high quality supplements regardless of what you decide to take. Many products contain fillers and other unnecessary ingredients that are not good for you. I will also tell you a few of my favorites brands, but in reality, there are many reputable brands out there. As always, look at the list of ingredients, so that you can see what is in them.

Finally, make sure you tell your physician about any supplements you are taking, particularly if you are on any prescription medication. Certain vitamins can interact with prescription medications, so it is of upmost importance you consult with your physician.

Ok, without further ado, lets explore the what vitamins I should take? question :

Multivitamins

Why?

In an ideal world, where we all ate the right amounts of healthy, nutritious foods, there would be no need to take a daily multivitamin. However, the reality is that most of us eat certain things that we shouldn’t and we often eat too little of the things that we should. In addition, there are several studies showing that, because of our current farming practices and the overuse of our soil, our fruits and vegetables do not contain the same amount of vitamins and minerals that they used to contain decades ago.

According to the National Health and Nutrition Examination Survey (NHANES), 93% of Americans had inadequate dietary intakes of vitamin E, 44% had inadequate intake of vitamin A and 31% of vitamin C. In addition, 56% had inadequate magnesium intake. Some deficiencies varied by particular populations. For example, vitamin B6 deficiency was a problem for females over 50 years of age. Zinc deficiency was a problem for males and females over 70 years of age and females 14–18 years of age. Vitamin K, calcium, and potassium seemed to also be of concern. Finally, for both vitamin D and calcium, only about one-third of individuals aged one year and over showed an adequate intake. This deficiency was even more pronounced in 14-50 y/o females.

Which one?

Given our current climate, I think a solid multivitamin is an essential supplement we should take. Some vitamins can be harsh on our stomachs, so I always suggest taking them with food. As always, I like the pure encapsulation brand, they have several formulations depending on your particular needs and age. Also, their products are of high quality. I have put a list of multivitamin suggestions on our purecaps page. If you don’t really like pills and would prefer liquid vitamins, I really like Mary Ruth’s Organics vitamins. She has a morning formulation with vitamins and a nightly formulation with minerals. Also, they are great tasting and vegan. As always, feel free to explore what works best for you, there are so many options! There are even powder vitamins that you blend with your smoothie in the morning and forget about it for the rest of the day.

Fish oil

Fish oil has been extensively researched in the last 30-40 years and with good reason! It has been shown to be very important for heart health (strongest research backing), among several other benefits.

Fish oil and Omega-3

Fish oil contains omega-3 fatty acids. Omega-3 fatty acids can be found not only in fish, but also in nuts, flax seeds, vegetable oils and leafy green vegetables. However, only fish contains the omega-3 fatty acid subtypes called DHA (Docosahexaenoic acid) and EPA (Eicosapentaenoic acid). Nuts and vegetables have another type of Omega-3 fatty acid called ALA (Alpha-linolenic acid).

With our Western diets, we tend to get more than enough ALA, but not so much EPA and DHA. Some of the ALA is converted into DHA and EPA, so do not despair if you are vegan. Although nowhere near fish level, you do get a little benefit from this ALA conversion.

What is the role of omega-3 fatty acids in our body?

Well, omega-3 fatty acids are essential for our cell membranes and the receptors in those membranes. They are important for hormone formation and they help keep inflammation in check.

Fish oil has been studied in asthma, brain development, heart disease, cholesterol, body fat composition, Alzheimer’s prevention and, most recently dry eye prevention, to name a few conditions.  

Some types of omegas may be more effective for certain ailments than others. For example, a study comparing DHA vs EPA, showed that DHA is more effective than EPA in modulating specific markers of inflammation as well as blood cholesterol. Other studies suggest that DHA is more efficient in decreasing blood pressure, heart rate and platelet aggregation compared to EPA (all important in heart disease development). It also seems to be better for control of irregular heart rhythms. So, for heart health, DHA heavy fish oil may be better.

For mood disorders, such as depression, the data becomes muddier. Although the brain and the eye have the highest concentration in the body of DHA, studies for mood disorders have been inconclusive. Some studies suggest that DHA is better, while others suggest EPA is more effective for depression.

Overall, we need more data to know the exact doses, effects and benefits that fish oil provides, but overwhelmingly it seems to be helpful for multiple organ systems.

What is a good dose?

It would be great if we could all eat our omega-3 dose straight from the source! However, we would have to consume obscene amounts of fish to obtain the recommended amount. 

In terms of dosing, the Food and Agriculture Organization of the United Nations recommends a dose of 250 mg/day of EPA plus DHA for adult males and non-pregnant/non-lactating adult females. The American Heart Association recommends about 1 g/day of EPA plus DHA for patients with known coronary heart disease, and 2 to 4 g/day for patients requiring triacylglycerol lowering.

There are many brands of fish oil out there, but many of them are of low quality and may be contaminated. I alternate between liquid and capsules. Obviously for travel purposes capsules are better. You can check out pure encapsulations, they have a large variety of fish oils and I also really like this liquid brand by Omega Cure.

Probiotics

This is the third supplement I think we should all take. I will not spend a lot of time discussing this supplement because we have spent two previous posts (you can check them out here and here) discussing the importance of the microbiome and its effects on health.

In those posts, I also provide several recommendations as to my favorite probiotic brands and the strains you should look for in your probiotics, so make sure you check them out. You can also look at my recommendations in our Purecaps business page and purchase them directly.

To end

I hope everyone found some useful information to help you make your supplement choices. Please feel free to reach out here if you have any questions.

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See you next week! 💕

Michelle Ramírez, MD