How to Choose Quality Supplements and When to Consider Taking One
The supplement market is a confusing place. There are so many supplements to choose from at varying prices from a few quid in the supermarket ailes to eye watering prices endorsed by celebrities. To save you hours of consulting Dr Google and comparing ingredient lists, I’ve comprised a mini guide to help you choose a quality supplement that supports your nutritional needs.
The role of supplements
I will always advocate for diet first. If you aren’t eating a varied whole food, minimally processed, colourful and anti-inflammatory diet then there is only so much supplements can do. Think of supplements as a crutch. They are there to offer additional support in times of need but shouldn’t be relied upon for healing.
Do I need a supplement?
If you eat a varied and balanced diet and are in good health, then you probably don’t need to take a supplement. For some people, and in certain circumstances, supplements can really help.
Always check with your healthcare provider before starting a new supplements, espeically if you are on medication, immunocompromised, are pregnant or breast feeding.
When to consider supplements
YOU ARE VEGAN
B12 (cobalamin)
Needed for: healthy blood cells, formation of myelin sheaths for nerve health, methylation and preventing B12 deficiency aneamia
Supplemention: there are 4 forms of B12: cyanocobalamin, hydroxycobalamin, methylcobalamin and adenosylcobalamin. Cyanocobalamin is the most common and cheapest form but the body needs to convert it to the active forms, methylcobalamin or adenosylcobalamin. Cyanocobalamin contains a minuscule amount of cyanide (hence cyano) which needs to be detoxified and eliminated. Hydroxycobalamin is a precursor form of vitamin B12 that is converted in the body to both methylcobalamin and adenosylcobalamin.
I recommend the active forms of B12 which are methylcobalamin or adenosylcobalamin. Adenosylcobalamin is particulalry helpful for supporting mitochondrial health and energy production.
If you have low stomach acid, pernicious anemia, or comprimised digestion, such as in Crohn’s disease, you may find sublingual supplmentation (under the tongue) more beneficial than capsules. Sublingual administration allows the B12 to be absorbed straight into the bloodstream.
Safety: B12 has very low toxicity so no clear upper tolerable limit has been determined. Clinical case reports have found that doses of 5,000 μg or more of B12 per week may worsen acne. From experience I was taking a daily B complex with 270 μg B12 and that aggrivated my acne prone skin.
Iron
Needed for: the formation of red blood cells, thyroid health, oxygen transportation, formation of myglobulin in muscle, co-factor for many enzymes, generation of ATP, neurotransmitter synthesis.
Supplemention: ferrous fumarate is most common but can cause gastrointestinal upset including nausea and constipation. Ferrous bisglycinate is a gentle and highly bioavailable form (better absorbed and used by the body). Iron is best taken with vitamin C which enhances iron absorption.
Heavy periods, internal bleeding, IBD, heavy sweating and parasitic infection can all contribute to iron deficency.
Safety: Don’t supplement without knowing your iron levels. Pay particular attention to your hemoglobulin (70% of iron is found in the hemoglobulin of red blood cells) and ferritin (stored iron).
The NHS refernce range for hemoglobulin is 130 – 170 g/L for males and 120 – 150 g/L for females. However, from a functional medicine persepective levels for adults ought to be 133 g/L to 167 g/L. The NHS reference define ferritin deficiency as <15 ug/L for adults. However, ferritin under 30 ug/ L can contribute to fatigue, poor performance and hair loss. When my ferritin dipped to 16 ug/ L I was extremely fatigued and losing hair. For optimal health ferritin levels ought to be 60 – 110 ug / L.
The safe upper tolerable level of iron is 40 mg.
Don’t take iron if you are fighting an infection. Iron can feed the pathogen.
Omega 3 fatty acids
Needed for: managing inflammation and oxidative stress, flexible cell membranes, brain, skin, eye, reproductive and gastrointestinal health.
Supplemention: fish oil is the best source of omega 3 fatty acids (I like Bare biology) but if you’re vegan then opt for algea oil (like this one by Bare biology or Nordic Naturals algae omega).
Safety: do not take omega 3 supplements if you are on blood thinners like warfarin or are about to have sugery as they can increase the risk of bleeding.
Calcium
Needed for: healthy bones and teeth, relaxation and contraction of smooth muscle in blood vessels, blood clotting, function of the nervous system and reducing the risk of colon cancer.
Supplemention: calcium carbonate is cheap and a lot of foods are fortified with this form of calcium including plant based milks, cereals, breads and crackers. Di-calcium malate, calcium citrate and calcium bisglycinate chelate are good forms of supplemental calcium.
Safety: before supplementing eat calcium rich foods such as dairy and canned fish with bones. Vegan friendly sources of calcium include: dark leafy green vegetables, almonds, sesame and poppy seeds, and carob.
If you have been told you need to supplement with calcium you may be better off taking a multi rather than calcium alone. Vitamin A, D3, K2, magnesium and boron all work synergistically with calcium.
The tolerable upper intake of calcium is 2500 mg per day for adults aged 19 – 50 years. It’s 2000 mg for adults over 50 years.
You live in a winter climate/ far from the equator
Vitamin D (calcitriol)
Needed for: healthy bones and teeth, regulating gene expression, regulation of calcium and phosphate levels, immune health including being beneficial for autoimmune diseases, brain health and hormonal health.
Supplemention: vitamin D3 is more effective at raising vitamin D levels than vitamin D2. In the UK the NHS recommends supplementation of vitamin D3 from October to March at 800 IU daily for adults.
Vitamin D deficency is defined as levels under 25 nmol/L but levels under 50 nmol/ L indicate insufficent levels. Optimal levels are around 75 to 100 nmol/ L.
Vitamin D is fat soluble. Those who have had gallbladder removal have a reduced ability to absorb fat soluble vitamins so are at increased risk of vitamin D deficency. Magnesium is a co-factor needed for metabolism of vitamin D.
Safety: the upper tolerable limit is 4000 IU (100 μg) a day. I recommend taking vitamin D3 with K2 and getting sources of magnesium in your diet (green leafy vegetables, legumes, nuts, seeds, wholegrains). Vitamin D increases calcium absorption and vitamin K2 sends the calcium to bones, reducing the risk of the calcium depositing into soft tissues. Do not take vitamin K if you are on blood thinning medication.
You are highly stressed
Vitamin B5 (pantothenic acid)
Needed for: supporting the adrenal glands in times of stress, is used in the Krebs cycle to make energy and helps form the neurotransmitter acetylcholine which contributes to mental performance, concentration, learning and memory.
Supplemention: look for calcium pantothenate or D-calcium pantothenate. B5 can be taken alone or in a B complex.
Safety: no upper tolerable limit has been set as there are few to no reports of toxicity, even at high doses.
Folate, B12, B2, B6
Needed for: methylation of catecholamines (dopamine, adrenaline, noradrenaline) in order to deactivate them and excrete them from the body, allowing you to calm down.
Supplemention: best taken as a B-complex. Good options include methyl B complex by BioCare, B-complex select by Moss Nutrition, B-complex plus by Pure Encapsulations, active B-complex by Integrative Therapeutics, B complex plus by Seeking Health, Stress B-complex by Thorne and vitamin B complex by Metagenetics.
When it comes to folate, look for methylfolate (5-methyltetrahydrofolate/ 5-MTHF). Folic acid is the synthetic form of folate that has to be methylated and relies on your methylation working well.
Safety: B2 (riboflavin) can turn urine bright yellow, this is harmless. B3 (niacin) can cause flushing at doses of ≥50 mg, this usually passes and is harmless. B3 in the form of nicotinamide is not associated with flushing. High levels of B12 can worsen acne (I was put on a very high dose, 20,000% of the RNI, and my skin erupted but I am very prone to nodular acne and cysts).
There is no established upper intake for B1, B2, B5 and B12. The upper tolerable intake for B3 as nicotinic acid is 35 mg/d as nicotinamide is 900 mg/d , for B6 is 12 mg/d and for folate (B9) is 1,000 mcg/ d.
Magnesium
Needed for: calming the nervous system, muscle relaxation, regulating neurotransmitters. Low magnesium levels are a stressor to the body and ongoing stress can deplete magnesium levels.
Supplemention: magniesum comes in many forms. Magnesium glycinate is a calming form that’s particularly beneficical for anxiety and sleep. Magnesium malate is helpful for reducing pain, cramping and fatigue. Magnesium citrate addresses constipation. Magnesium taurate is good for blood sugar balance, blood pressure and heart health. Magnesium threonate can cross the blood brain barrier so is particularly beneficial for brain health.
Safety: levels over 350 mg daily can cause diarrhoea.
Zinc
Needed for: supporting immune health, stress resilliance, reducing anxiety (zinc deficiency is linked to increased stress and anxiety), and reproductive health.
Supplemention: there are many supplemental forms of zinc. Zinc bisglyincate and zinc picolate show good bioavailabilty.
Safety: the upper tolerable limit is 40 mg per day. If supplementing, I’d recommend 15 to 30 mg per day.
Zinc and copper have a complex relationship and need to be in balance. Too much zinc can cause copper deficiency and vice versa. Dietary sources of copper include organ meats, oysters, salmon, tofu, chickpeas, potatoes, cashews, sunflower seeds, and wholegrains.
Adaptogens
Needed for: modulating the body’s response to stress.
Supplemention: options include ashwaganda, astragalus, tulsi/ holy basil, ginseng, rhodiola, lemon balm, liquorice, maca, rhodiola, cordyceps, lion’s mane, maitake and reishi.
I recommend doing a little research as each adaptogen has specific benefits beyond stress. For example liquorice is also benficial for gastrointestinal health, cordyceps aid immunity and astragalus can be helpful for upper respiratory tract infection and common colds.
I like to drink adaptogenic drinks. I particulalry like Pukka’s tulsi tea and my mum is a fan of TRIP drinks. I also have a mushroom mix in a powdered form that I add to soups and stews.
Safety: those with high blood pressure should not take liquorice as the glycyrrhizic acid can raise blood pressure. Deglycyrrhizinated liquorice may be safer. Ashwagandha may be contraindicated in PCOS.
How long does it take for a supplement to work?
This depends on multiple factors:
- The supplement: quality, bioavailability, compatability with your body’s needs.
- Your condition: years of comprimised gut health will take longer to heal than vitamin D deficiency.
- Your lifestyle: if you are leading a healthy lifestyle (good nutrition, movement, stress management) that supports healing then you’d see results quicker.
In general, you should feel an improvement in your symptoms within 6 weeks. Although, hormonal imbalances, skin conditions, and gut issues can take around 12 weeks (3 months) for a noticable difference to occur.
What to look for in a good supplement
Not all supplements are created equal. Many are formulated with cheap, inactive form with unnecessary excipients.
- Read ingredients: Many cheaper supplements contain few active (bioavailable) ingredients. They’re often ‘bulked up’ with fillers, binders and sugars (I’m looking at you hair gummies) or contain GMOs or heavy metals (especially fish oils).
- Dosage: You shouldn’t need to take multiple pills a day to meet the recommened dosage. And a mega dose of a nutrient can cause more problems than it solves. For example, a mega dose of vitamin A or D3 can cause liver damage.
- Bioavailibility: This simply means how readily available for absorption are the ingredients? Look for “bioavailable,” “optimized,” or “active form” so your body can use the nutrients more easily.
- Co-factors: Often nutrients are best taken in a synergistic mix. No nutrient in your body works in isolation, it needs co-factors for enzymes to be able to be activate it and metabolise it. For example, iron is better absorbed with vitamin C so a supplement may contain ferrous bisgycinate (iron) and ascorbic acid (vitamin C) or sources of vitamin C such as citrus pulp or rosehip.
- Certification: Look for a certification like ‘GMO free’, ‘Informed choice’, ‘NSF’ (National Sanitation Foundation), ‘GMP’ (Good Manufacturing Practice). When purchasing fish oil look for IFOS (International Fish Oil Standards).
- Transparency: Does it say where it’s made? Is there contact info?
- Education: Do the company/ brand offer support with selecting supplements? Do they mention contraindications or safety precautions? I feel in safer hands when supplement companies have a practitioner or education section. It means they are willing to share information about their supplements and the science behind them.
Where to buy supplements
I would advise buying your supplements from a reputable brand’s website or online retailer rather than the supermarket. Supermarket supplements tend to have poor formulations.
Options include:
- The Natural Dispensary
- Amrita
- Turmeric & Honey
- Healf
- A brands own website
- Health stores
❀ ❀ ❀
I hope the above information has helped you better understand the confusing world of supplements. Before we depart and I go and put the kettle on for my fifth herbal tea of the day, I just have a few notes:
- Diet first. I will always advocate for nutrition over supplements where possible. Your first port of call should be focusing on eating a variety of wholefoods to ensure your body is recieving all the micronutrients (minerals and vitamins) and macronutrients (protein, fats, carbohydrates) that it needs to function at its optimum.
- Be selective. You don’t need 20+ supplements; quality over quantity. In general, 1 – 5 should cover your needs.
- Introduce one at a time. When starting a new supplement it’s best to introduce them one at at time to monitor how your body responds. Ideally, give it at least 3 days before you introduce another supplement.
- Re-evalute your supplements every 12 weeks. Have you noticed any positive differences in your symptoms? Do you still need the supplement?
- Seek medical advice. Okay, I’m doing my due diligence here. DISCLAIMER: seek medical advice when starting new supplements, especially if you are pregnant, have any underlying health issues, or are currently on medication(s).
References
Brown, B. (2023, Jul). Nutritional dermatology: acne vulgaris. Pure encapsulations: health professional education.
Borowski, T. (2024). Mapping iron & anaemia tendencies. Amrita practitioner roadmap series. https://www.amritanutrition.co.uk/pages/educational-events
Disilvestro, Robert., & Swan, M. (2008). Comparison of Four Commercially Available Zinc Supplements for Performance in a Zinc Tolerance Test. The FASEB Journal. 22. 10.1096/fasebj.22.1_supplement.693.3.
Hedberg, N. (date unknown). The ferritin level test. Dr. Nikolas Hedberg. https://drhedberg.com/the-ferritin-test/
Furness, D. (2023, Aug). Methylation masterclass: understanding methylation & nutritional co-factors. Pure Encapsulations. https://pure-encapsulations-pro.co.uk/education/webinars/
NHS. (2024). Ferritin. NHS North Bristol. https://www.nbt.nhs.uk/severn-pathology/requesting/test-information/ferritin
National institutes of health. (2022, Oct 18). Copper. https://ods.od.nih.gov/factsheets/Copper-HealthProfessional/
Solberg, A., & Reikvam, H. (2023). Iron Status and Physical Performance in Athletes. Life (Basel, Switzerland), 13(10) https://doi.org/10.3390/life13102007
