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Supplements

Filling a measured gap

Test first

Supplements correct deficiencies. They do little for people who are not deficient. In the VITAL trial, 25,871 healthy adults took vitamin D or placebo for five years, and vitamin D did not reduce cancer or cardiovascular events1. But when the blood level is low, replacing it is standard care2. That is why this site asks for your blood work before it suggests a pill.

What has evidence

Vitamin D3, when your level is under 30 ng/mL: 1,000 to 2,000 IU a day, rechecked after three months2.

Vitamin B12, when low or borderline, and for everyone on a vegan diet. Long-term metformin lowers B123. A level under 200 pg/mL needs a doctor to find the cause4.

Iron, only for confirmed deficiency and with a doctor, because the cause of the loss must be found5.

Psyllium fibre, about 10 g a day, lowers LDL cholesterol by roughly 13 mg/dL6.

Omega-3 at 2 to 4 g a day lowers high triglycerides by 20 to 30%7. For most people two servings of oily fish a week is the better route.

Magnesium lowers blood pressure slightly, about 2 mmHg8.

Creatine monohydrate, 3 to 5 g a day, improves strength and muscle gain with resistance training and has a long safety record in healthy people9.

Protein powder is food, not medicine. Use it only if you cannot reach your protein target from meals. Benefits for muscle level off at about 1.6 g per kg of body weight a day10; older adults need at least 1.0 to 1.2 g per kg11.

Buying well

Supplements are not tested for purity or accuracy before sale in the United States. Choose products certified by an independent lab (USP Verified, NSF Certified, or Informed Choice), in the plain form named above, without proprietary blends. Tell your doctor and pharmacist everything you take.

References

  1. Manson JE et al. Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease. N Engl J Med. 2019. PubMed 30415629 · Full text
  2. Holick MF et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011. PubMed 21646368 · Full text
  3. Aroda VR et al. Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study. J Clin Endocrinol Metab. 2016. PubMed 26900641 · Full text
  4. Stabler SP Vitamin B12 deficiency. N Engl J Med. 2013. PubMed 23697526 · Full text
  5. Camaschella C Iron-Deficiency Anemia. N Engl J Med. 2015. PubMed 26222573 · Full text
  6. Jovanovski E et al. Effect of psyllium (Plantago ovata) fiber on LDL cholesterol and alternative lipid targets, non-HDL cholesterol and apolipoprotein B: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2018. PubMed 30239559 · Full text
  7. Skulas-Ray AC et al. Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association. Circulation. 2019. PubMed 31422671 · Full text
  8. Zhang X et al. Effects of Magnesium Supplementation on Blood Pressure: A Meta-Analysis of Randomized Double-Blind Placebo-Controlled Trials. Hypertension. 2016. PubMed 27402922 · Full text
  9. Kreider RB et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017. PubMed 28615996 · Full text
  10. Morton RW et al. A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. Br J Sports Med. 2018. PubMed 28698222 · Full text
  11. Bauer J et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013. PubMed 23867520 · Full text

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