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Let me start by saying that, a supplement by definition is a supplementation NOT a replacement for food. You cannot over-supplement a poor diet, period. If you can get a sufficient amount of a certain nutrient from a food source, it is always preferable to supplementation as nutrients from food sources in many cases are more bio-active, come with other ingredients necessary to aid the absorption of that nutrient, and can help avoid overdosing. In an ideal world, we can all grow our organic produce of many varieties in our lush soil, raise livestock on our grassy fields, and get all the nutrients and minerals we need from our plates. But most of us don’t live in this ideal world and have to rely on store-bought products that are not nearly as nutrient-dense. In my opinion, we all need a well-researched customized supplement regimen. And here is why.
THE WHY FOR SUPPLEMENTS
The why is we eat a lot of calories but little nutrients. Let’s face it, It’s hard to make sure every meal is well put together to provide all the nutrients our body needs. According to a 2015 CDC study, only 9% of US adults ate the recommended amount of vegetables and 12% ate the recommended amount of fruits. Even if you do manage to put together well-balanced meals day in and day out, the food produced by our modern agriculture today is not nearly as nutrient-dense as they were for our grandparents. Decades of modern farming have depleted our soil of nutrients. That combined with GMOs, and over-application of pesticides and antibiotics makes our food much less nutrient and to some extent more harmful. The average vegetable found in today’s supermarkets is 5-40% lower in mineral content than those from 50 years ago. Industrialized food processing also strips our food sources of many key nutrients. For example, milling strips whole grains off husks where most of its fiber, B vitamins, and phytochemicals are concentrated. All of the above factors lead to the situation we are in today: we eat a lot of calories but few nutrients.
Lastly, more and more people have special dietary restrictions, be it Vegan or Paleo (myself is dairy and gluten-free), it is more likely that you can’t get the full spectrum of nutrients from food, which makes supplementation even more vital in this increasing group of people.
To fill in the gaps, we need high-quality supplements. But how in the world do we know where to start what to take, in what form, and from which brand when there are tens of thousands of options out there? But don’t worry, in this blog, I will walk you through all you need to get started including:
1) a foundational supplement regimen that most people can benefit from
2) a more advanced supplement regimen that most women over age 35 can benefit from (what I take)
3) lists of supplements that are optional but can be beneficial to specific groups from time to time
I FOUNDATIONAL SUPPLEMENT REGIMEN
I believe most people can benefit from those 4 core supplements: a multivitamin, a Vitamin D, a fish oil, and a probiotic – “the foundational four”.
Multi-vitamin:
A good broad-spectrum multivitamin can fill in where your diet leaves off. Think about it as an insurance that covers nutrition deficiencies that come up from time to time. A basic multi-vitamin typically contains fat-soluble vitamins such as vitamins A, D, E, and K and water-soluble vitamins C and B-vitamins including B1 (thiamin), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), Vitamin B6, B7 (biotin), B9 (folic acid) and Vitamin B12. It usually also contains minerals such as iron, iodine, selenium, and zinc – all nutrients essential to maintaining healthy bodily functions.
The manufacturers publish their recommended serving size, it is important to not exceed the recommended serving size as certain ingredients can become toxic when you exceed the upper intake limit. A general rule of thumb is water-soluble vitamins (such as Vitamins B&C) are easily transported around the body and any excess can be eliminated through urine and therefore less problematic if over-consumption occurs. Fat-soluble vitamins such as A, E, and K are more susceptible to overdosing as they are stored in fat cells and the liver and can build up to toxic levels over time. An example of this would be Vitamin A intoxication which can lead to headaches, digestive issues, and skin rashes. One exception to this general rule is Vitamin D, which is fat-soluble but there are no known negative effects from taking too much Vitamin D, we will walk through Vitamin D later in this article. Although many multivitamins can be taken on empty stomachs without causing harm given many of the vitamins are fat-soluble, it’s better to take those with meals rich in fat for best results. For detailed recommendations on daily multivitamins based on my research, please refer to our article here.
Some of my favorite multi-vitamins are here:
Designs for Health Twice Daily Multi:https://www.amazon.com/designs-health-Twice-Daily-Multi/dp/B000FGXLVE/ref=sr_1_1?crid=10SLCZSQ3YLZI&keywords=designs%2Bfor%2Bhealth%2Bmultivitamin&qid=1699898887&s=digital-text&sprefix=designs%2Bfor%2Bhealth%2Bmulti-votamin%2Cdigital-text%2C81&sr=1-1-catcorr&th=1
New Chapter Every Woman’s Multivitamin:https://www.amazon.com/New-Chapter-Multivitamin-Probiotics-Ingredients/dp/B00FBPEVP4/ref=sr_1_6?crid=2FP3Q9VLMWNKS&keywords=new%2Bchapter%2Bwomen%27s%2Bbasic%2Bmultivitamin&qid=1699899100&sprefix=new%2Bchapter%2Bwomen%27s%2Bbasic%2Bmultivitamin%2Caps%2C64&sr=8-6&th=1
Vitamin D:
Have you ever gone on a beach vacation and come back feeling a whole lot better? Vitamin D is called “sunshine vitamin” for a reason. Unlike most other vitamins, it’s very difficult to get Vitamin D from food sources, but when exposed to sunlight, 7-dehydrocholesterol in the skin absorbs UVB radiation which is ultimately converted into Vitamin D3. Vitamin D is essential to maintain proper neuromuscular functions, bone integrity, and muscle strength. It is also necessary in calcium absorption and plays an important role in our reproductive health.
With the population migrating from farm fields to offices and with the wide usage of sunscreen (often necessary to prevent wrinkles and skin cancer), almost all of us are deficient in sun exposure, and therefore our Vitamin D levels dip well below the optimal level. To make matters worse, if you live north of 37-degree latitude (San Francisco), you barely make any Vitamin D on your own in the winter months from November to March due to UVB being absorbed by the ozone layer when the northern hemisphere tilts away from the sun.
According to a 2011 research published in the National Institutes of Health database 42% of the U.S. population are deficient in Vitamin D. That percentage estimate might understate the problem as most labs define a normal range of Vitamin D level at 30-100 ng/ml while 30 ng/ml is the minimum threshold, more health experts agree now the optimal range for Vitamin D is above 40.
My suggestion is to add Vitamin D level to your next physical exam (it’s a simple blood test that can be added to your annual blood exam), and supplement based on the results. If bloodwork does show a deficiency, at your health provider’s discretion, you can start with a high dosage supplementation and once the levels climb back to their optimal level, maintain Supplementation at 2,000 IU daily. You should also consider varying the Vitamin D supplement dosage based on where you live and the time of the year. I, for example, live in the Northeast, and I don’t take daily Vitamin D supplements during summer when I get enough sunlight outdoors but I up my dosage coming fall and winter to supplement the lack of UVB we get up here during those months.
Some of my favorite vitamin D are here:
Thorne Research Vitamin D-1000:https://www.amazon.com/Thorne-Research-Vitamin-Supplement-Capsules/dp/B0797H3VQS/ref=sr_1_3?crid=1ZRDI1H0DOVD0&keywords=thorne%2Bvitamin%2Bd%2B2000&qid=1699899584&s=hpc&sprefix=thorn%2Bvitamin%2Bd%2B2000%2Chpc%2C82&sr=1-3&th=1
Probiotics:
Our digestive tract is home to a diverse population of bacteria, both good and bad. The balance of this microbiome is a key determinant of our immunity function and well-being as 70-80% of immune cells live in the gut. No wonder Hippocrates famously and wisely said, “All disease begins in the gut” thousands of years ago. Our gut microbiome is under daily attack from antibiotics (or food sources that contain antibiotics and pesticides), chemical compounds frequently found in processed foods, environmental toxins, etc and therefore it is vital to reinforce the good bacteria population with a high-quality probiotic supplement that contains at least 10-30 strains of good bacteria, mostly commonly Lactobacillus acidophilus.
It is also recommended to feed your good bacteria well with their favorite food – prebiotics, which mostly consist of plant fiber. I take a combination of probiotics and prebiotics. You can also opt to take a symbiotic which is composed of both probiotics and prebiotics. See our article on probiotics and prebiotics here.
Some of my favorite probiotics are here:
Terraflora Daily Care Synbiotic:https://www.amazon.com/gp/product/B07G7GK2N1/ref=as_li_qf_asin_il_tl?ie=UTF8&tag=yesicom05-20&creative=9325&linkCode=as2&creativeASIN=B07G7GK2N1&linkId=9c24323978f12bdd9ce7bdb6cbd5c3b4
Garden of Life Formulated Probiotics:https://www.amazon.com/Garden-Life-Formulated-Probiotics-Guaranteed/dp/B00Y8MP4G6/ref=sr_1_5?crid=U963N5SU622F&keywords=probiotics+dr+formulated&qid=1699916691&s=hpc&sprefix=probiotics+dr+formulated%2Chpc%2C97&sr=1-5
Fish oil:
Omega-3 fatty acids are an essential part of our cell membrane but our body does not produce that essential nutrient and it can only be obtained through diet and supplementation. Omega-3 are powerful anti-inflammatory. Its cousin Omega-6 is pro-inflammatory which is also necessary and it’s essential to maintain the optimal ratio of Omega 3 to Omega 6 for proper brain, cardiovascular, respiratory, immune, and musculoskeletal health.
According to research published on the National Library of Medicine in 2002, the human race historically evolved on a diet with a ratio of Omega-6 to Omega-3 essential fatty acids of approximately 1:1. The modern Western diet however has an Omega-6 to Omega-3 ratio of a whopping 15:1. A very high omega-6/omega-3 ratio promotes inflammation which leads to many diseases, including cardiovascular disease, cancer and autoimmune diseases.
As such, we need to 1) control the intake of Omega 6 by cutting down on processed seed and vegetable oil and 2) increase our intake of Omega 3 through either fatty fish and/or Omega 3 supplements. Typically individuals need to supplement with 500-900mg of omega-3 fatty acids to meet optimal levels. I vary my Omega 3 supplement dosage with my diet: for example, if I had salmon for lunch, I would cut back on my Omega 3 supplement that day.
Some of my favorite fish oils are here:
Nordic Natural Ultimate Support:https://www.amazon.com/Nordic-Naturals-Ultimate-Support-Healthy/dp/B002CQU564/ref=sr_1_4_pp?crid=1RYU467M7JYP5&keywords=nordic+fish+oil&qid=1699918643&s=hpc&sprefix=nordic+fish+oil%2Chpc%2C76&sr=1-4
Green Pasture Fermented Cod Liver Oil Liquid:https://www.amazon.com/Green-Pasture-Cinnamon-Tingle-Liquid/dp/B00NEEDKTC/ref=sr_1_4_pp?crid=31D6D3RQ9JZ3H&keywords=green%2Bpasture%2Bcod%2Bliver%2Boil&qid=1699918567&s=hpc&sprefix=green%2Bpasture%2Bcod%2Bliver%2Boil%2Chpc%2C79&sr=1-4&th=1
II ADVANCED SUPPLEMENT REGIMEN
In addition to the foundational 4, Women over 35 can also benefit from adding in an antioxidant, calcium, and magnesium. This is the regimen I take daily.
CoQ10
I believe most people over age 35 can benefit from supplementation of antioxidants which protect our cells from damages caused by free radicals – the root cause of many age-related diseases. My choice of a basic antioxidant is CoQ10, which is a substance naturally found in every cell in the body. CoQ10 levels decrease as we age and CoQ10 from food sources are unlikely to be high enough to raise CoQ10 levels in the body, making supplementation appropriate as we age. The absorption rate is low for CoQ10, however. I would recommend taking Ubiquinol, the bioactive form of CoQ10 for better absorption and also taking the supplement with a meal rich in fat as CoQ10/Ubiquinol is fat-soluble.
Some of my favorite CoQ10 are here:
Life Extension Super Ubiquinol: https://www.amazon.com/Life-Extension-Ubiquinol-Enhanced-Mitochondrial/dp/B00H4HT0EE/ref=sr_1_2_sspa?crid=2VVA2KVOOOHS7&keywords=ubiquinol&qid=1699977147&s=hpc&sprefix=ubiquinol%2Chpc%2C82&sr=1-2-spons&sp_csd=d2lkZ2V0TmFtZT1zcF9hdGY&th=1
Protocol for Life Balance Ubiquinol: https://www.amazon.com/Protocol-Life-Balance-Cardiovascular-Antioxidant/dp/B005HXT5J2/ref=sr_1_5?crid=39ATDRZOBD026&keywords=ubiquinol+protocol+for+life&qid=1699977406&s=hpc&sprefix=ubiquinol+protocol+for+life%2Chpc%2C67&sr=1-5
Calcium
Women are 4 times more likely to get osteoporosis, a permanent loss of bone density. As we age, our estrogen which regulates bone metabolism drops especially around menopause, and leads to osteoporosis, a non-reversible but preventable condition. The NIH recommends 1,000 mg of calcium a day for women ages 19 to 50 and 1,200 mg a day for women 51 and older. The highest concentration of calcium in food sources is in dairy products and you need 3-4 servings daily. But if you are lactose-intolerant or Vegan or simply do not eat dairy, it is important to consider a calcium supplement. I also think women over 40 would benefit from taking a calcium supplement as a precaution to prevent osteoporosis as our estrogen starts to decline.
A note of caution is calcium can only be absorbed and used by the body with the help of Vitamin D and Vitamin K, otherwise unused excess calcium can lead to calcification of vascular tissues. So it’s important to make sure you have adequate Vitamin D and K when taking Calcium supplements.
Some of my favorite Calcium are here:
Pure Encapsulations Calcium (without Vitamin D & K add-in): https://www.amazon.com/Pure-Encapsulations-Hypoallergenic-Highly-Absorbable-Supplement/dp/B00172XUWU/ref=sr_1_13_sspa?crid=3JV6M858FCIMA&keywords=calcium&qid=1699977853&s=hpc&sprefix=calcium%2Chpc%2C97&sr=1-13-spons&sp_csd=d2lkZ2V0TmFtZT1zcF9tdGY&psc=1&smid=A2EJCTH67GJMT3
Pure Encapsulations Calcium (with Vitamin D & K add-in): https://www.amazon.com/Pure-Encapsulations-Hypoallergenic-Elemental-Supplement/dp/B00M1W8B7O/ref=sr_1_5?crid=3ST27WK749HLC&keywords=calcium+with+vitamin+d+and+K&qid=1699978025&s=hpc&sprefix=calcium+with+vitamin+d+and+k%2Chpc%2C78&sr=1-5
Magnésium
Magnesium is one of 15 or so essential minerals the body needs and is especially important for proper function of the muscular and nervous system. But arguably it is one of the most deficient nutrients in our population. According to the World Health Organization, an estimated 75% of American adults don’t meet the FDA’s Recommended Daily Intake. Magnesium is contained in food sources such as nuts, seeds, and whole grains. However, the refining process we use today in our food industry strips away germ and bran where magnesium is concentrated leading to magnesium deficiency in most of the population.
Therefore magnesium supplementation becomes necessary, whether orally through a magnesium supplement or transdermal by rubbing magnesium oil onto your skin. I have made it a nighttime ritual to apply magnesium oil to the bottom of my feet to calm my nervous system before I go to bed.
Some of my favorite Calcium are here:
The Heart of Tradition Ultra Pure Topical Magnesium (external application):https://www.amazon.com/Transdermal-Magnesium-Oil-Zechstein-Inside%C2%AE/dp/B07D5MJ65C/ref=sr_1_4?crid=1JGTXK1J82A70&keywords=organic%2Bmagnesium%2Boil%2Bin%2Bglass%2Bbottle&qid=1699978316&s=hpc&sprefix=organic%2Bmagnesium%2Boil%2Bin%2Bglass%2Bbottle%2Chpc%2C78&sr=1-4&th=1
Thorne Research Magnesium Citrate (supplement):https://www.amazon.com/Thorne-Research-Citrate-Malate-Production-Metabolism/dp/B0797SJ88Y/ref=sr_1_3_sspa?crid=1ATEYENXL4U7S&keywords=magnesium+supplement&qid=1699978437&s=hpc&sprefix=magnesium+supplment%2Chpc%2C83&sr=1-3-spons&sp_csd=d2lkZ2V0TmFtZT1zcF9hdGY&psc=1
III. OTHER BENEFICIAL SUPPLEMENTS:
In addition to the foundational supplements, I also take a few others from time to time based on what my body needs:
Folic acid / Folate (vitamin B9):
It plays a key role in the function of DNA in all cells. Most multivitamins include some folic acid/folate but specific groups might need additional supplementation including women of childbearing age and older adults. It is well established that supplementation of folic acid in pregnant women can effectively prevent neural tube defects in babies. Research also shows up to 1 in 5 adults over the age of 50 are deficient in folate due to potential malabsorption. As a matter of fact, Absorption is a common problem with this nutrient: 60% of US adults have an MTHFR mutation which means their ability to convert folic acid, a synthetic form of Vitamin B9 into a bio-active form that can be used by the body is compromised. You can choose to test for this genetic mutation or if you don’t want to, just stick with folate which is a natural form of Vitamin B9 for better absorption.
Some of my favorite folates are here:
Life Extension Optimized Methylfolate:https://www.amazon.com/Life-Extension-Optimized-L-Methylfolate-Vegetarian/dp/B00UD0IPYU/ref=sr_1_7?crid=2HKUZEDXU02KD&keywords=folate+supplement&qid=1699978694&s=hpc&sprefix=folate+supplement%2Chpc%2C68&sr=1-7
Prebiotic fiber supplements:
In simple terms, prebiotics are food for probiotics. Prebiotic is an undigestible fiber that gets eaten (fermented) in the lower digestive tract by probiotics. Food rich in prebiotics includes asparagus, onions, garlic, shallots, leeks, scallions, broccoli, cauliflower, kale, Brussels sprouts, cabbage, and artichokes. When my diet does not have a large amount of the above food, I would add a scoop of prebiotic to a smoothie as a fuel pack for my gut buddies!
Some of my favorite prebiotics are here:
Pure Encapsulations Poly-Prebiotic Powder: https://www.amazon.com/Pure-Encapsulations-Poly-Prebiotic-Bifidobacteria-Akkermansia/dp/B07T7Z2TTV/ref=sr_1_4_pp?crid=11TLOBBHQPHBS&keywords=poly-prebiotic+powder&qid=1699979129&s=hpc&sprefix=ppoly-prebiotic+powder%2Chpc%2C63&sr=1-4
Enviromedica Terraflora Synbiotic (has both probiotics and prebiotics): https://www.amazon.com/Enviromedica-Terraflora-Synbiotic-Supplement-Capsules/dp/B07G7GK2N1/ref=sr_1_13_sspa?crid=3FOJRTB7A7JTO&keywords=prebiotic+supplement&qid=1699978986&rdc=1&s=hpc&sprefix=prebiotic+supplment%2Chpc%2C76&sr=1-13-spons&sp_csd=d2lkZ2V0TmFtZT1zcF9tdGY&psc=1
NMN/NR:
NAD+ (nicotinamide adenine dinucleotide) is a co-enzyme that is naturally occurring in our all cells boosts cellular energy and facilitates cellular repair. By middle age, our NAD+ level drops by half which leads to aging. Studies have shown supplementing NMN and NR (both are NAD+ precursors) can boost intracellular NAD+ levels and therefore slow down aging. Given the promising results in animal studies, currently, NMN is being studied as a potential drug, therefore NMN is no longer sold as dietary supplements in the US, but its precursor NR is available and there have been 10+ published peer-reviewed clinical studies that demonstrate its effectiveness and safety in human. I have noticed a helpful energy boost on low-dose NR supplements.
Some of my favorite NR supplements are here:
Tumeric / Curcumin:
Curcumin is a natural compound that looks bright yellow in turmeric and has been used as a medicinal herb for thousands of years in Asia. Many studies have found that curcumin is a very powerful antioxidant and is also anti-inflammatory. The concentration of curcumin in turmeric is low at 3% however, which makes it difficult to get enough curcumin to reach clinically significant levels to be effective by eating food spiced with turmeric or drinking a golden latte. Compared to food sources, supplementing with highly concentrated curcumin extract is much more effective. Research also shows piperine contained in black pepper enhances curcumin absorption by up to 2,000%.
Some of my favorite curcumin supplements are here:
HOW TO SELECT SUPPLEMENTS?
Supplements are not regulated by the FDA for efficacy or safety, which puts the burden of selecting high-quality supplements on the consumer. It’s truly a myriad of information to go through. I evaluate supplement brands based on the following criteria: 1) Research and science-driven; 2) Independent Third-party tested and certified; 3) meet GMP (Good Manufacturing Practice) standard; 4) free of artificial fillers; 5) free of common allergens. In this article, I walk through my methodology in detail.
In a nutshell, here are some of the brands I trust based on my research, alphabetically:
Designs for Life
Garden of Life
Life Extensions
Pure Encapsulation
Thorne
THE VERDICT
With our modern food sources and lifestyle, supplementation is necessary and important especially as we age if chosen carefully. I hope this blog serves as a launch pad for you to build your supplementation routine. I won’t expect an overnight shift in our health from adding those supplementations; yet, those little things we do every day will compound into a much healthier and more youthful future that we can look forward to.