The Supplement Saga



The supplement aisle at the chemist gives me a headache and it seems I am not alone – my patients will often ask me what they should be taking and I’ve had many of you approach me on Instagram asking for a blog on the topic. So here it is – my attempt at providing some guidance (which is no way replaces a visit to the GP to answer you’re specific needs). I agree with many of you that between cranberry, gingko biloba and calcium supplements it’s hard to know what you need and what you don’t.


I’ve had bursts of “I’m going on a huge health kick – I’m going to get supplements, exercise, lose weight and just nail life,” and I suspect you’ve had those moments too. You end up in the discount pharmacy drawn to all sorts of weird and wonderful supplements that can make you fit and fabulous. So if I get sucked in and I’m meant to know better – I can see how my patients struggle.


The truth is if you have a balanced diet and no underlying medical problems technically you should not need any supplements. You should be getting all the wonderful vitamins and minerals you need through your food.


And the truth is some supplements aren’t as safe as you think they might be. Just because they scream natural and come without a prescription doesn’t mean they are completely safe. For instance, good old fish oil can make it harder for your blood to clot so some surgeons won’t operate on their patients until they have stopped fish oil because of bleeding risk!



Women planning pregnancy/ pregnant or breastfeeding:


The guidelines recommend women planning pregnancy take a supplement with at least 150 micrograms of iodine and 400 micrograms of folic acid in it everyday for 4 weeks before they try to conceive and continue this for at least the first trimester. Both iodine and folic acid are vital for a baby’s development and it’s believed the latter can help reduce the risk of spina bifida (a disorder where the spinal cord does not correctly form).


I will always suggest women who are pregnant or planning pregnancy go on a pregnancy specific vitamin to avoid products like Vitamin A, which can be in normal vitamins but dangerous in pregnancy.


So if you fall into this group – a pregnancy specific supplement is definitely worth considering!


But what about calcium supplements?


We try and advocate that people get their calcium from their diet. For some reason patients love taking calcium supplements – but truth is as doctors we only recommend this for a very small portion of the population as there is some evidence (and this is hotly debated in the medical world) that it can increase your risk of heart attacks.


So taking the supplement because you think you need it isn’t necessarily the right thing to do. It’s worth speaking to your GP or trying to get the required amount of calcium from your diet instead. All you need is 3-4 serves per day and it isn’t all dairy – nuts, green leafy vegetables and tofu can also give you the required calcium hit!


Do I need to take iron tablets? (Something I commonly get asked)


No, we don’t all need iron supplements!


The figures suggest 15% of non-pregnant woman suffer from iron deficiency. Some symptoms of iron deficiency include fatigue, shortness of breath when you are physically active and pale skin – if you’re concerned you’re at risk seeing your GP is the first step not only to confirm the diagnosis with a blood test but also to investigate why you are iron deficient (which includes taking a good history and examination). If you have confirmed iron deficiency then yes you may a need supplement – but if it’s mild we may talk about dietary factors instead and if it’s a significant deficiency you may need iron infused through your vein (as tablets may not be enough). With constipation and an upset belly as some of the side effects of iron tablets, it’s not a supplement you want to take unless you really need it!


I see a lot of patients on iron tablets for no particular reason and truth is if you are having 2-3 serves of red meat a week and you eat green leafy vegetables then chances are you are getting enough iron. Of course there are certain people in the population with gut disorders that affect their ability to absorb iron and they may well need the supplement for long periods.



And what about these wonder tablets- the all in one “helps with energy/weight loss/amazing skin” tablets?


Oh dear – we all get sucked in by this at some point don’t we?


You have this desperation to be healthy and feel great and a tablet that offers all these things seems like the perfect step!


Alas no there is no natural supplement that will “improve your energy levels and help you lose weight quickly.” Unfortunately weight loss will always be best achieved through diet changes and exercise and popping a pill just isn’t going to cut it for the long-term changes you really want!


And what about this Probiotic business – do they work or not?


Essentially probiotics are yeast or bacteria that you can get in a capsule, powder or yoghurt. Some people take these every day “just because” – and given probiotics are generally regarded as safe it isn’t too much of a problem.


Truth is the hard medical evidence only stands behind probiotics for treatment of infectious diarrhea when it’s caused by a virus and for preventing diarrhea due to antibiotic use. Interestingly, there is also some evidence that taking a probiotic when travelling can reduce your risk of pesky traveller’s diarrhea – so worth a shot! But a probiotic every day “just because” is not likely doing a huge amount for you!





So the truth is if you’re fit, healthy and eat a balanced diet you likely don’t need a supplement! Save yourself some money- buy more fruit and vegetables, get moving and shaking and you’re likely going to do a lot more good for your health than popping a supplement.


But – if you fall into one of the groups I’ve mentioned above who should be on a supplement OR you think you might like to investigate a specific one further – it’s always worth asking your GP what they think. I know for my patients I’ll try to answer their questions with the most evidence I possibly can (even if I have to look up articles in the consult) so that they can make an informed decision for themselves.


I’d rather you checked with me before you popped a pill you didn’t need!