How do you know if you need to take a supplement?
Dr. Parikh: As the name implies, a supplement is meant to add whatever you’re not getting enough of through your diet. It’s very important that we think about supplements as an addition to what we’re supposed to get from food.
Even though I do recommend supplements to my patients, I always tell them it is a bridge; supplementation is to fix a deficiency until you get your diet up to a level where it is enough. So I always tell people: Before you think about whether you’re missing out on a nutrient or not, ask yourself if you’re eating an ideal diet. Think about adopting more of a Mediterranean diet and plant-based diet, and steer away from more processed food and fast foods.
And this is true also for children: We should take the opportunity to train our kids in eating a healthy, well-balanced diet. It’s not about eating candy and then eating a multivitamin gummy.
Should we talk with our doctor before taking vitamins or supplements?
There’s no downside in getting a baseline blood test. These can be done as part of your routine annual physical. I treat supplements the same as I do any medication: If I’m prescribing a medication, I’ll first give a blood test. For instance, if I’m prescribing a medication for diabetes, I first check the person’s blood to make sure they have diabetes; then I check how serious it is and see what the right dose of medication will be. Then I’ll repeat the blood test to make sure the medication is working and if I need to adjust the dose.
I do the same when considering supplements. Often when I see my patients for the first time, I will get a baseline set of blood tests to check their vitamin and mineral levels to see if they’re deficient in any of them. Vitamins such as iron, B12, folate, and D can be easily checked through a blood test. A complete metabolic panel will often check for things like sodium, potassium, and calcium. From there I may suggest a multivitamin if someone is low in more than two or three different vitamins.
What should a person look for if they’re shopping for a supplement or multivitamin?
Check the label for daily value percentages. For instance, if it says vitamin C, 200%, that basically tells you that you are getting about 200% of your daily recommended value of vitamin C. I tell my patients that you want to be somewhere between 50% to 200%.
If you’re shopping for a multivitamin, make sure the ingredient list lists all the vitamins with their daily value percentages.
Another thing to be mindful of is that vitamins can be categorized into water soluble and fat soluble. Some vitamins like A, D, E and K are fat soluble, and it’s possible to overdose or get too much of them. That’s one reason a blood test is really necessary; you want to understand whether or not you need a certain vitamin, what dose is appropriate, and whether or not you’re absorbing the right amount.
Your body can eliminate excess doses of water-soluble vitamins. Examples of water-soluble vitamins are vitamin C, and the B vitamins like folate and b12. But if you’re taking fat-soluble vitamins, then you wouldn’t necessarily want to exceed the daily recommended values.
Are there certain populations or age groups for which supplements are highly recommended?
Absolutely. Pregnant women require supplementation because of their dietary and nutritional needs. And it’s important they get their blood test done as part of their routine checkups to make sure they’re taking the right doses.
If someone has IBS issues or an autoimmune disease of the gut that impairs their ability to absorb vitamins and nutrition from food, they would benefit from supplementation.
The elderly population might also need supplementation, if an individual’s diet isn’t varied enough.