Whether or not to take vitamins or supplements can be a bit of a contentious issue.  I always ask patients if they are ok with taking them (when it's appropriate), if they can swallow pills, or if we should look at other treatments.  I am not a Naturopathic Doctor that recommends 1000 pills a day, but I have come to appreciate just when, why, and how supplements can be appropriate and beneficial.  

Why are supplements needed?

They aren't always, but here are some common reasons.

• Inadequate nutrient intake
  - soil is depleted
  - food is processed & refined
  - less sun in the winter months (vitamin D is more of a hormone, but it's still a supplement)
  
  
• Increased need or demand for nutrients
  - using up or losing more than we take in - this is common with vitamin B12, iron, magnesium  (e.g. many people use up B vitamins in the detox process and supporting the nervous system)
  
  
• Medications can cause depletions
  - 55% of Canadians aged 18-79 have taken one prescription medication in the last month, 36% have taken two, and 24% have taken three or more (1)   (Did you know it was this high?!)
  
  
• To shift or optimize biochemistry
  - sometimes we would like to temporarily push the body's chemistry one direction or another to support a process, or have a desired outcome  (e.g. antioxidants support tissue healing), or because of genetic variations that make certain forms of vitamins less usable
  
  
• Treating or preventing specific conditions

How to Choose a Good Quality Supplement

• Read the ingredients like you would your food
  - no fillers (e.g. rice)
  - no binders or shellac (talc, titanium dioxide or other things that make you wonder if it's meant to be eaten)
  - no common allergens (dairy, nuts, wheat, corn, etc.)
  
  
• Absorbable and useful forms of the vitamin or part of the plant
  - you may need help with this one, but the form of vitamin can make it more absorbable or efficacious
  - different parts of plants can have varying therapeutic value
  - capsules tend to be better absorbed than tablets (sorry Flintstones)
  
  
• Dosages & Quantities
  - the term "proprietary blend" is not helpful to me, but can still be a helpful product
  - sometimes you need to take several capsules to reach the desired dose -> check the serving size
  - some professional brands contain a lot higher dosages 

Common Drug-Nutrient Depletions
Some of the most commonly prescribed or over the counter medications come with a consequence of depleting nutrients - by blocking absorption, requiring them for breakdown, or other means - which can lead to other downstream effects.  (This list is by no means comprehensive.)

1. Antacids/Acid Suppressors (e.g. proton pump inhibitors, H2 antagonists)
   - calcium, folic acid, iron, vitamin D, vitamin B12, magnesium, zinc
   -> potentially leading to bone loss, anemia, fatigue, high blood pressure, cervical changes, hair loss
   
   
2. Oral contraceptives & hormone replacements
   - vitamin B6, probiotics, magnesium, folic acid, vitamin A, C, E, selenium
   -> anemia, depression, skin issues, lowered immunity, cervical changes, hair loss
   
   
3. Cholesterol lowering drugs (e.g. statins)
   - coenzyme Q10, vitamin D
   -> possibly leading to heart failure
   
   
4. Corticosteroids (e.g. prednisone)
   - calcium, magnesium
   -> bone loss, fatigue, immune suppression & poor wound healing, blood sugar dysregulation, etc.
   
   
5. Blood sugar lowering medications
   - folic acid, vitamin B12, coenzyme Q10
   -> may cause increased cardiovascular disease & cancer risk, fatigue, anemia
   
   
6. Diuretics
   - potassium (unless potassium sparing variety), magnesium, zinc
   
   
7. Anti-anxiety medications
   - melatonin
   -> insomnia, depression, low growth hormone
   
   
8. Antibiotics
   - varied, depending on the type

How to take your supplements
Make sure you read the instructions or follow your practitioner's directions.  Some are best absorbed with food, or on an empty stomach, or away from other vitamins or medications.  When I prescribe, I do my best to make it as simple as possible - opting for more pills, fewer times per day - because that's the only way I am compliant, so I assume you might have a similar challenge ;)

If you find yourself nauseous with supplements, try taking with your largest meal (as long as food isn't contraindicated), spreading out the doses, or consider low stomach acid levels creating this symptom.

(It's a good idea to talk this through with me, or another practitioner, to test for or decide on a treatment plan.)

We carry some professional supplement lines at the clinic, or you can find them on my online Dispensary.  We also have some great local retail options.  

I hope this finds you well,
Dr Christa
 
1.  https://www150.statcan.gc.ca/n1/daily-quotidien/210628/dq210628e-eng.htm

Autumn HealthSummer is all about the chill factor - rest, unwind, watch the waves, have fun ... We get away with the extras because we have extra sunlight, downtime, and fresh foods.  For most of us, whether we have school-aged kids or not, the fall is a nice return to routine.  Now, we need to have honest conversations about how we will rebuild your health.  It's been a long time of immune suppression, stress, binging...  

We can often power through when we need to, followed by a crash, but powering through requires a solid base from which can can pull, a stockpile of resources - just like the squirrels are building right now.  Nature gives us clues on what to do, and this is the period of time we are in right now.  Changes in season are the best opportunity to set the stage for the time to come.

When you are looking to establish new routines, there are several things to consider.  Here's a past article I wrote about preparing for the fall, many of these same concepts are applicable now.

• Sleep - the body loves routine, and establishing a sleep schedule is part of that pattern
  - you know how you function best, and for most people it's between 7 and 9 hours of sleep per night
  
  
• Eat - as the weather changes we need more warming foods like garlic, cinnamon and soups
  - there are still lots of fresh foods in season to take advantage of:  peaches, tomatoes, and soon apples and squash
  
  
• Move - make it a goal to move in some way every day for your mental and physical well-being
  - the soon to occur fall colours will be amazing to enjoy, but there are many opportunities for movement.  It's also good to plan how you will continue being active through the winter - will it be yoga classes, home gyms, swimming, skiing or outdoor hikes?
  
  
• Know yourself
  - are you someone that needs a reset to get started? (fall detox group to come soon), are you someone that gets sick every October? (time to discuss ways to support the immune system now), do you get overwhelmed or sad in November? (build some stress management or joyful habits now)
  
  
• Get some updated bloodwork
  - I've found it's been a few years since most people have had regular bloodwork.  You can have it done with your family doctor's office, or I can order it for you (not covered by OHIP through me... the typical screening tests like blood sugar, cholesterol, liver enzymes, and complete blood count will generally cost about $100).  This is a good opportunity to catch things before they become a more challenging obstacle to health.

I have been pretty sad to see this summer wind down, but look forward to creating health this fall.

Here are a few easy recipes for some inspiration :)
Creamy Rainbow Coleslaw 
Brownie Batter Protein Balls
Golden Turmeric Latte
Beef and Bean Minestrone Soup


See you soon,
Dr. Christa

 
Rest.  Eat well.  Move everyday.  Go into nature.  Connect.  Find joy.
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