Dr. Mark Moyad, MD, MPH,. The Jenkins/Pokempner Director of Complementary and Alternative Medicine at the University of Michigan Medical Center, is the only U.S. physician with an endowed position to study dietary supplements, and author of The Supplement Handbook: A Trusted Expert’s Guide to What Works and What’s Worthless for More Than 100 Conditions.
Have supplements been proven to perform comparably or better than conventional treatments for certain conditions?
Here are just three that are changing medicine for countless patients:
- Alzheimer’s Disease: One of the longest and best clinical trials, published in the Journal of the American Medical Association, showed that people with mild to moderate Alzheimer’s taking 2000 IUs of vitamin E daily in addition to standard meds/acetylcholinesterase inhibitor drugs had a 6+ month reduction in functional decline and reduced caregiver time by two hours daily. An earlier trial (New England Journal of Medicine) also showed benefit at the same dosage. (Note: Vitamin E has not been shown to prevent Alzheimer’s or help mild cognitive impairment.)
- Macular Degeneration: Based on the 2013 Age-Related Eye Disease Study 2, the National Eye Institute recommends this formula for patients with intermediate to advanced stages of age-related macular degeneration, as it’s been shown to prevent vision loss! (It does not prevent the disease):
- 500 mg vitamin C (ascorbic acid)
- 400 IU vitamin E (dl-alpha-tocopheryl acetate)
- 25−80 mg zinc (zinc oxide)
- 2 mg cupric oxide
- 10 mg lutein
- 2 mg zeaxanthin
- Migraines. The American Academy of Neurology recommends butterbur extract for migraine prevention. Taking 75 milligrams of the Petadolex brand (containing ~15% petasins) twice a day reduced frequency of migraine attacks by about half, with maximum response achieved after 3 months.
Unfortunately, the vast majority of supplements do not have solid research behind them, and people take them without knowing whether they’re necessary or safe.
How should consumers determine what supplements they need?
First, get heart and mentally healthy. With good diet and exercise, try on your own to achieve healthy cholesterol, blood pressure, blood sugar, and weight—the big preventive numbers that make or break whether or not you’re predicted to live a longer, healthier life. Only afterwards decide if you need some pill support for major issues. So, for example, if you have high cholesterol or male sexual dysfunction that can’t be controlled by diet and exercise, you might try red yeast rice or L-citrulline supplements (these for one month) respectively. Research shows countless drugs work better in someone who’s fit or healthy; it’s true for some supplements as well.
Second, if a physician says you’re low in a particular nutrient, do targeted dieting first. If you’re low in calcium, for example, both almond and cashew milk are great sources; you can get practically all the calcium you need just by drinking 2 cups of Blue Diamond almond milk daily.
Third, choose supplements proven to help treat conditions, diseases, or their side effects, instead of taking supplements for general prevention, except for a multivitamin, which was proven to help a little: Centrum Silver reduced both cancer and cataract risk in men and cataract risk in women.
Fourth, if you’re taking prescription medications, find out if a supplement is needed to rectify any nutritional deficiencies that are "quiet" drug side effects. Many real nutritional deficiencies occur from medication use, such as acid reflux drugs and the diabetes drug metformin lowering magnesium and vitamin B12 levels.
Why do you recommend avoiding supplements for prevention, except for a multivitamin? Just because scientific study hasn’t yet proven their value doesn’t mean value might not exist.
The clinical evidence is not there to decide right now, and the brilliant Hippocratic oath, "first do no harm," is just as relevant today. Taking supplements without evidence can have dire consequences. For example, the largest U.S. dietary supplement trial found a higher chance of prostate cancer and perhaps aggressive prostate cancer in healthy men taking high-dose vitamin E (400 IU daily) and/or selenium (200 micrograms daily), especially when they had replete levels of the nutrients in their blood. Daily doses of 1000+ mg Vitamin C over just a few weeks can dramatically raise oxalate levels in the urine and increase kidney stone risk. Mega-doses of certain athletic supplements may hinder exercise benefits by not allowing oxidative stress to signal to the body that it needs more mitochondria or cellular changes to build long-term endurance.
Most importantly, research shows that accomplishing these 7 heart-healthy habits—exercising regularly, eating a healthy diet, eliminating tobacco exposure, and maintaining healthy weight, blood pressure, blood sugar, and cholesterol level—without taking any supplements will increase your odds by 80% - 90% of living to 85+ with no or little physical or mental disability. No dietary supplement or drug has been shown to match these effects, or even come close.
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