Choosing Supplements Wisely
A lot of us in the autoimmune community take supplements. Sometimes they help, sometimes they harm, and sometimes they do nothing at all. Today, we’re going to learn how to make informed choices when it comes to supplementation. My guest is the director of Examine.com, a website that shares unbiased research into supplements and nutrition. Disclaimer: Neither Kamal nor I are medical professionals. This program is educational and is not a substitute for medical advice. Always consult with your doctor when adding supplements to your healthcare protocol.
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Show Notes
- Intro (0:00)
- Thank You to Our Podcast Sponsor: Paleo on the Go (1:24)
- A frozen meal delivery service, they have a large menu of items for the paleo autoimmune protocol (AIP).
- Use the code PHOENIX for 10% off your first order.
- Meet Kamal (3:31)
- Kamal is the director of Examine.com. His passion for nutrition began in college, originally related to his goal to gain muscle, but eventually with a focus for pain relief. Kamal has Ehlers-Danlos Syndrome, a condition that results in faulty collagen production, which left him prone to injuries and joint pain.
- What Is Examine.com? (7:19)
- It’s a website that shares unbiased research into supplements and nutrition. They don’t sell supplements, nor do they have any relationship with supplement manufacturers. The vast majority of what they offer is free.
- They do sell 2 additional resources to help cover expenses: Supplement Guides and a Membership Program that unlocks a deep research database.
- How Examine.com Analyzes Research (7:38)
- Examine.com looks at all studies through a Human Effect Matrix: (1) Was this study done on humans rather than animals? (2) How large was the beneficial effect – strong, notable or minor? (3) How strong is the evidence for that effect? Was it a large study? Do other studies confirm the results? And what was the quality of those studies? (4) What were the demographics of the population studied – gender, age, race, health status, etc.?
- Be wary of media headlines which exaggerate results, and abstracts which can summarize results in a biased way. You need to look at the entire study.
- Examine.com employs research specialists to analyze the full research and report it in layman’s terms.
- Resource Articles:
- Supplements vs. Diet and Lifestyle (16:30)
- Even though Examine.com focuses on supplements for health, here’s what they say on their website: “Our recommendation is to always fix your diet, exercise, and sleep before worrying about supplements.” Lay the foundation first. They are the most powerful interventions.
- Resource Article: Where Supplements Fit on a Healing Diet.
- Supplements for Sleep (19:19)
- If you’re struggling with sleep and need immediate relief, Kamal recommends sustained release melatonin, but only for 1-2 days at a time. To truly address sleep problems, listen to podcast episode 94: Troubleshooting Sleep.
- Supplements for Pain (21:25)
- If you’re considering opioids for pain relief, try supplements first, since they are less addictive with fewer side effects.
- Try supplements one at a time, as a controlled self-experiment.
- It’s difficult to address pain, because there are many potential causes. However, one supplement Kamal recommends trying is Curcumin. Research shows that it can help with pain and inflammation. There are two kinds: (1) Supplements that have been enhanced to be more bio-available: BCM95, Meriva, or Black Pepper/Bioperine (2) Pure curcumin which isn’t bio-available, but then focuses completely on gut inflammation. You can experiment with both kinds.
- Resource Article: Turmeric & Autoimmune Disease.
- Vitamin D (27:36)
- Vitamin D is one of Kamal’s research specialties.
- He recommends testing your Vitamin D levels and ensure you aren’t deficient. There’s a lot of controversy on optimal levels, but Kamal said that 35-50 is a healthy range. Elevating your levels to 80-100 carries risks for developing other health problems.
- His recommended method of getting Vitamin D is sunshine. Take advantage of the summer; your body will store the Vitamin D for winter.
- Resources:
- Article: Sunshine Medicine.
- Podcast Episode 179: Vitamin D and Autoimmune Disease.
- Gut Health (40:54)
- The gut is a great target for supplementation, because all you need to do to is swallow. There’s no worry about bio-availability or reaching a different area in the body where you’re experiencing the problem.
- Supplements Kamal recommends for gut health are: pure curcumin, zinc-carnosine (combined), and EGCG green tea. He said he can’t name them all, but this is a good place to self-experiment.
- Collagen (42:58)
- Overall, Kamal thinks this supplement is over-hyped. If you have trouble with your joints or skin, it’s worth experimenting , but it’s not a miracle cure. The one area of research that shows promise is rheumatoid arthritis. Undenatured collagen capsules can potentially have an immunosuppressive effect.
- How Long to Take a Supplement (44:56)
- Kamal doesn’t believe in taking supplements forever. However, he also says when experimenting with supplements, you need to take them at least one month to test the potential benefit. This often means buying two bottles, not just one.
- Probiotics (45:26)
- When it comes to probiotics, there’s a lot we don’t know. They’ll never do research comparing fermented foods to probiotic supplements, because who would fund it? Some people tolerate fermented foods better than probiotics – and vice versa – so this is an area where you can experiment.
- If you do take probiotics, Kamal recommends taking prebiotics simultaneously – this is food that helps the bacteria multiply. Always start small – open the capsules and take a little of the powder first and slowly titrate up over the course of days, based on how your body responds. If you are dairy-intolerant and/or following the paleo autoimmune protocol, read labels carefully and choose a dairy-free brand.
- New research into probiotics is also changing old beliefs. For example, they found that many times, probiotic supplements actually don’t contain live bacteria. So the expectations is that they wouldn’t be therapeutic. But a study found that the dead bacteria can have a positive effect on the immune system as well.
- Another example of changing information is that helminths were once considered a parasite to be eradicated and now they are being studied as a therapy for autoimmune disease.
- Additional Resources:
- Magnesium (52:30)
- Magnesium is an important supplement but also over-hyped. It’s not a miracle cure, but it can be a helpful supplement since many people are deficient. Avoid magnesium oxide which is poorly absorbed by the body. Chose chelated magnesium supplements instead. Mineral water and trace mineral supplements can also be helpful.
- Resource: Episode 205: Magnesium and Autoimmune Disease with Dr. Guillermo Ruiz.
- How to Do a Supplement Self-Experiment (55:07)
- Don’t buy into supplement hype. They aren’t panaceas and don’t make up for unhealthy diet and lifestyle choices. However, they can sometimes be helpful with symptom management.
- Disclaimer: This podcast is informational and not a substitute for medical advice. Always consult with your doctor before doing supplement experiments.
- Research supplements fully through Examine.com. Consult with your doctor. Choose one to try, and try it for a full month. If it helps, continue taking it. If it hurts, stop taking immediately. And if it makes no difference, stop taking at the end of the month trial. The only exception to this rule is a supplement that has strong clinical evidence for addressing your health concern in a way that you cannot feel. Then, you might take it longterm based on your doctor’s advice.
- Kamal also clarifies between complements and supplements. He sees complements as filling in something that’s deficient in your diet or lifestyle (such as magnesium or vitamin D), and those are usually safe to take longterm. Supplements address a medical concern and should be approached like a medication experiment. Tell your doctor. Try one at a time. And be aware that there are very few studies done on the longterm effects of supplementation.
- Reading Labels and Supplement Fraud (1:00:12)
- Read labels carefully so you know what’s in the bottles and look for an allergen statement. Many supplements contain things like corn, soy, dairy, nightshades, gluten and other grains.
- Beware of supplement fraud. Buy from brands you trust. Don’t shop for the cheapest price. Look for quality testing done by independent labs. For example, IFOS tests quality for fish oil supplements. You can also verify your supplements with a watchdog website like: Labdoor.com.
- Outro (1:06:11)
- Examine.com shares unbiased research into supplements and nutrition. The vast majority of what they offer is free. They do sell 2 additional resources to help cover expenses: Supplement Guides and a Membership Program that unlocks a deep research database.
- Eileen (your podcast host) is the author of multiple books, written to help people thrive with autoimmune disease. Learn more on the Books Page.
- If you like this podcast, follow or subscribe through your favorite podcast app. You can also subscribe to Eileen’s biweekly newsletter.
- Check out the entire archive of podcast episodes.
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This is my favorite interview on your podcast! I am so glad that my doctors have prescribed me a lot of supplements that have extensive research behind them, too. Kamal was a great guest!
Wonderful! I’m so glad you enjoyed the episode. I agree, Kamal is so knowledgeable!
Hi, Eileen,
I like the idea of Examine.com, but I feel confused by some of the things I read on that website, versus some of the things I’ve read about nutrition elsewhere in the paleo world (and like what we heard from Dr. Jack Wolfson, on your podcast). When Kamal Patel mentioned something at the end of the podcast about milk fat and heart disease, I went to Examine.com and entered ‘saturated fat’ in the search bar. One of the first links to come up was “How can I best ensure cardiovascular health and longevity?” I clicked on that and saw several key points, from a meta analysis, that seem contrary to what I’ve learned about saturated and polyunsaturated fats, e.g. “Red meat consumption increases overall mortality rate by 31% in men, 35% in women.” How selective is Examine.com about which studies they report on?
I’m not trying to be contentious, just to understand if they regularly report on correlative and causal studies without making a distinction between the two.
Our maybe I don’t really understand the important points on nutrition that I thought I did. 🙂
Holly, you’ve stumbled upon the truth of nutrition research – there are lots of conflicting studies out there. If there weren’t, everyone worldwide would agree on what constitutes the healthiest diet. Examine.com is a research summary portal; it’s not a paleo website. The article you reference was specific findings from just one meta-analysis from 2010. It wasn’t a summary of all the research available on red meat and saturated fat. This article on Examine.com seems to summarize the research rather than report on just one analysis, and it states that it’s a myth that saturated fat and red meat are bad for you: https://examine.com/nutrition/awful-nutrition-myths/. If you’re looking for more details, Chris Kresser has done some of the most complete research and analysis of red meat and saturated fat, which you can find here: https://chriskresser.com/heart-disease/. Where Examine.com shines is in its supplement research specifically. That’s where it synthesizes information from all of the studies using the matrix described in this podcast. For example, here’s their curcumin page: https://examine.com/supplements/curcumin/. They don’t do that for general nutrition topics like “saturated fat”. If you want to dive into the research yourself, Chris Kresser also has an article on how to read research critically: https://chriskresser.com/how-to-read-and-understand-scientific-research/. And if you want to keep up with emerging research, Examine.com has a monthly research digest: http://bit.ly/2mGSACO. I think it’s great that you have these questions, because it’s never a good idea to just take what we’re told on faith.
Longvida is another patented curcumin formula that is also been studied and can be found as supplement. I think Kresser promotes that form
Yes, Longvida is similar to Meriva. They both use a phospholipid structure to enhance absorption. The only objection I have to Longvida is that it’s soy-based. Meriva now has a soy-free version.
A simple Spectracell Micronutrient test has been a huge benefit to my health. Many nutrients are very difficult to measure but I think this can be an important missing piece for some.
Thanks for sharing, Trina. I have heard good things about that test!