Episode 89: Dietary Supplements: How To Know If They’re Effective And Safe

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Thanks for joining us for episode 89 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today we are answering the following question from a listener:

“How can you know if you’re absorbing vitamins, minerals, and supplements, especially if there is leaky gut or SIBO? I have heard that normal blood levels don’t necessarily mean the nutrients are getting into your cells and exerting an effect. I don’t want to spend money on supplements my body isn’t absorbing, and if blood levels don’t give that information, how can we know?

With so much fraud in the supplement industry, how can we know which brands of supplements contain what they claim, and even more are free of dangerous heavy metals that could just make things worse?”

With the vast amount of supplements on the market, it seems like there is a supplement for every health concern. But with little oversight in the supplement industry, it can be overwhelming to figure out which ones actually deliver what they claim. On top of that, we are left to wonder if our bodies are actually absorbing them. So how can you be sure what you buy is effective, and most importantly, safe?

Today we are diving into the topic of supplementation so you can come away with insight into determining if a supplement is right for you. Packed with much needed information and tips, just some of what we’re discussing in the podcast includes factors that affect absorption and utilization of supplements, types of products with a greater risk of heavy metal contamination, and ways to investigate the quality of a supplement.

Here’s what Laura and Kelsey will be discussing in this episode:

  • Factors that affect how you absorb supplements
  • Nutrients that can affect the absorption and utilization of other nutrients
  • When supplementation is preferable over just relying on dietary sources
  • Why liquid or powdered forms are preferred when dealing with digestive concerns
  • The effect of stress on digestion and absorption of nutrients
  • A practical stress relief exercise to enhance digestion
  • How paying attention to symptoms is the best way to determine if a supplement is beneficial
  • Why working with a practitioner is especially helpful when considering supplementation
  • Symptoms of common nutrient deficiencies
  • The importance of choosing high quality brands
  • Important factors to consider to be sure a supplement is appropriate for you
  • The types of supplement products that are at greater risk for heavy metal contamination
  • Ways to investigate the quality of a supplement


Links Discussed:


Laura: Hi everyone. Welcome to episode 89 of The Ancestral RDs podcast. I’m Laura Schoenfeld and with me as always is Kelsey Kinney.

Kelsey: Hey guys.

Laura: This is our first time back recording in 2017, so starting off a New Year. Kelsey and I always take I think a two week break at the end of the year from working with clients, and doing podcasts, and stuff just to kind get some…well it used to be downtime for me. It really wasn’t much downtime for this past two weeks like usual. But how was your holiday?

Kelsey: It was great. I was in Massachusetts for Christmas…Christmas Eve, Christmas, and a few days after that.  When I’m there I have three different families basically that I have to spend time with. My parents are divorced so my mom, my dad, and then my husband’s family are all in the same town. It’s kind of crazy to try to run around and see everybody. Christmas morning was crazy. I think we spent two hours in the morning with each family starting at 8 a.m. It was a little nuts, but really fun of course and ate a lot of good food, a lot of good food. Then we went with my mom to Montreal and that was great. It was really cold though.  It snowed a ton, but we were walking around. I think one day we did like 30 or 40,000 steps in a day, which is a lot.

Laura: Wow.

Kelsey: I guess sadly, that is fairly common when I travel to do that much walking. I don’t do that in my everyday life so my legs were kind of feeling it and all that, but I wasn’t lifting weights or anything so I think it was fine. I did some ice skating, which was fun. I haven’t done that in years and years and I was surprised that I actually remembered how to do it. I did not fall once, which was impressive.

Laura: That is impressive.

Kelsey: Yeah. Then on New Year’s Eve they had a really big free event and concert in Montreal. We were staying at an Airbnb right by that, and went out and I think here was 150,000 people there.

Laura: Wow.

Kelsey: It made it fairly warm actually when you’re standing in a crowd. I was worried that I was just going to freeze my butt off the whole time because you’re outside for three or four hours, but I was actually perfectly toasty will all those people surrounding me. But yeah, it was a really good time on all accounts. I would say my holiday was a success in that it was very fun, but as usual I feel like I didn’t relax as much as I probably should have.

Laura: Yeah, I was thinking that’s kind of an issue I had. I upgraded from one family to three families this year for Christmas as well. My fiancé and I were driving kind of all over the place in the last, I guess it was a good week we spent about twenty hours total of driving.

Kelsey: Wow!

Laura: He’s got two sets of parents kind of like you do and then I have just my one set, but I also have a brother and sister that live out of the area. In order to do as much family time as you did, we had to do a lot of driving.

Kelsey: Yeah.

Laura: We drove up to Michigan and back down to Ohio, and then we drove from Ohio to Maryland, and then we drove from Maryland to North Carolina. It was just a lot of car time.

Kelsey: Yeah, that is a lot.

Laura: Yeah, and lot of just going back and forth between different family locations. Last year I don’t know if I really saw any family over Christmas and New Year’s. I kind of just hung out at home and just took it easy, did some planning for 2016.

This year it was like nonstop stuff going on which was fun, but it was also really, really tiring. I guess we got to North Carolina and then we had some stuff planned. We had our engagement photo session which that was fun, but it was kind of tiring because you have to be kind of on when you’re doing that. Then the next day we had, I call it a marathon premarital counseling session with my pastor. It was funny because he’s like sometimes people take a few sessions to do this, but we’ll just see what we get done today. We ended up doing 5 hours total.

Kelsey: Oh my God!

Laura: It’s crazy, which is funny because honestly my fiancé and I have very few issues, I mean nothing serious and I think we actually talk about stuff very well. We emphasize communication. It was just kind of funny because it was going over this I guess assessment we had taken. But by the end of it, I was so tired and hungry and my fiancé was like, yeah, you started to lose a little color in your face by the end. I don’t know why that was exhausting.

Kelsey: I think I would too.

Laura: Yeah, so that was really tiring. The next day was New Year’s Eve and my fiancé and I went to work out with my trainer to do a little high intensity session with him. It was funny because we were planning on going out. I guess it’s been about two years since I had gone out on New Years’ eve. I was like it’s my first New Year’s Eve with my fiancé, I should do something fun, let’s go plan something. We were watching a couple of the bowl games going on, the collegiate football bowl games. My fiancé is a big Ohio State fan and we watched that catastrophe. I just kept falling asleep and I felt so bad because by the time 8:00 rolled around I was like I’m so sorry but I really don’t think I can go anywhere. I just am like dying. So we just ended up staying in and just having some cherry wine and watching some of the little specials going on. We got to see Mariah Carey’s epic diva fail, so that was kind of entertaining.

I just felt like such a grandma. I’m like oh man, next time I do New Year’s Eve I’m going to be 30, and I’m going to be married, and this is supposed to be my time of being young, and exciting, and going out. And I’m like in my pajamas drooling on my fiancé’s chest while he’s watching football. I’m like eh, I guess I’m not setting the bar too high for our marriage.

Kelsey: Yeah, right. I think that’s the nice way to spend New Year’s Eve actually. Normally that’s how I do it too. Going out to a concert was a big event for me for New Year’s Eve.

Laura: A change.

Kelsey: Yeah. But it’s kind of nice to have that one on one time and think about the following year, how you want to spend your time with your loved ones. I think that’s a nice way to celebrate it actually.

Laura: Yeah. It was weird. This year it was so different than last year just because last year was very self-reflective and I wrote all this stuff down about what I wanted the next year to look like. This year was just started off as being go, go, go visiting people, and then the last couple days was just basically me sleeping on my fiancé while he watched Westworld on HBO, and football, and stuff like that. I’m like, yeah, maybe I’ll have to spend this weekend as my year planning.

Kelsey: Mm hmm.

Laura: I looked over what I had written for 2016 last year and I actually saw a lot of things that I accomplished. I think sometimes writing stuff down even if you don’t have a specific plan for how you’re going to accomplish it, even if you just get clarity about what you want to do, it can actually help make things happen.

Kelsey: Yeah.

Laura: I definitely feel like I need to do that at some point. It’s not necessarily a resolution per se, it’s more things that I want to accomplish.

Kelsey: Mm hmm.

Laura: Or just changes I want to make to my daily life or my business, which I guess technically you could consider resolutions. I don’t really do the whole New Year’s resolution thing.

Kelsey: Yeah.

Laura: I usually just like to pick a couple of major accomplishments that I want to try to work towards and then also a word or kind of mantra that I want to focus on.

Kelsey: Yeah.

Laura: This year I think my focus is going to be on kind of a combination of connection and intimacy, so working on strengthening relationships with friends and family, and then also going from being engaged to being married I think is going to be a big shift.

Kelsey: Yeah.

Laura: Just being able to learn how to share life with another person is going to be a big adjustment so I kind of want to keep that as a major focus. We’ll see how that affects the business just because I’m sure that will somehow impact it.

Kelsey: Mm hmm.

Laura: I have to do a little bit of planning because I honestly did no New Year’s reflections at all this year, which is kind of unusual for me.

Kelsey: Yeah, I know. I didn’t do any of that yet either. It’s something that at least in the past I haven’t usually done a whole lot of reflection, but I’m kind of feeling like this year I really should. I guess I want to sort of envision what I want this next year to look like.

I agree, it’s not like a resolution per se even though there are things I want to accomplish. It’s more about how do I want my life to look over the next year and how can I get there? So kind of just making those steps and working toward that. I guess it is technically some type of resolution, but I don’t feel like I think about it that way.

Laura: Yeah. Like I said, when you write things down and you kind brainstorm about what you want your year to look like, it should just kind of be in the back of your mind when you’re making decisions as opposed to having some really concrete goal that you’re trying to accomplish.

Kelsey: Right.

Laura: I wouldn’t call it a resolution, but I think of it as an overall idea of what kind of accomplishments you want to work towards. I think it just guides your decision making in a way that helps you actually accomplish them.

Kelsey: Yeah. I think so too.

Laura: Cool. Well, I think we’re ready to get started with our question for today. But before we do, let’s hear a quick word from our sponsor:

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Laura: Okay. Our question today is somewhat of a two-parter. I’ll read the whole thing and then we’ll kind of talk about each part on its own. This person asks:

“How can you know if you’re absorbing vitamins, minerals, and supplements, especially if there is leaky gut or SIBO? I have heard that normal blood levels don’t necessarily mean the nutrients are getting into your cells and exerting an effect. I don’t want to spend money on supplements my body isn’t absorbing, and if blood levels don’t give that information, how can we know?”

Laura: A second related question is:

“With so much fraud in the supplement industry, how can we know which brands of supplements contain what they claim, and even more are free of dangerous heavy metals that could just make things worse?”

Kelsey: Alright. These are great questions. Honestly, I feel like once I started thinking about this question I was like I feel like I should think about this more because it’s not something I feel like I’ve spent a ton of time on. Obviously I do research on the supplements that I’m recommending to clients, and I choose good brands that I’m comfortable with, and all that. But it is a really good question when you start to think more about it because you often hear these stories in news about that they tested a particular supplement and it doesn’t contain any of what it says it contains or it contains harmful ingredients on top of the ingredient that you’re actually looking for. There’s just very little oversight of the supplement industry and that’s honestly a little bit frightening of course for a lot of us who take a decent amount of supplements over our lifetime. I definitely think this is a great question to think about and I’m really happy that this person asked it so that we can talk about today.

I would say in terms of the first part of this question that in general supplements have a very high amount of whatever vitamin, or mineral, or something like that. It’s high so that you can account for that lack of absorption because you’re not going to absorb everything that’s in a supplement. It just typically is not going to happen. Especially if you have something like leaky gut or SIBO that’s impacting your digestive system, you’re typically going to be taking supplements that have at least slightly over the amount that you actually really need to gain a benefit from the supplements. I feel like that piece of it is sort of built into the supplementation industry and how they produce supplements that they’re just giving you a little bit extra to account for the fact that you’re not going to absorb all of it.

Laura: Mm hmm.

Kelsey: Even if you do absorb everything that’s in that supplement, you’re not going to use all of it. Think about for example, B vitamins. When you take a B complex vitamin you will notice for a lot of you that your urine turns this bright green or yellow color. That’s just your body getting rid of I think it’s Riboflavin for that particular one. Basically your body just couldn’t use everything that you absorbed so it’s passing it through your urine.

Laura: Right.

Kelsey: It’s not necessarily harmful to get extra. Your body is just going to get rid of it.

Laura: One thing that that shows is that you know that you are absorbing it because you’re peeing it out. Because if you weren’t absorbing it, you would be pooping it out.

Kelsey: Right.

Laura: Not to be graphic, but to get into the urine, it needs to get absorbed into the bloodstream, and then filtered by the kidneys, and then put into the urine. That would indicate that your body is absorbing it because otherwise again it would come out in the feces and you wouldn’t see it in your urine.

Kelsey: Yeah, exactly. Then other things that can affect sort of how you absorb supplements is whether or not you’re actually deficient in that particular vitamin. For example, if you have a sufficient of that in your bloodstream or stored, your body doesn’t feel the need to absorb a whole lot of it from the food or supplements that you’re taking. That may be an example of another thing that if you don’t absorb anything, it may mean that you’re totally fine on that vitamin. You wouldn’t necessarily know that I guess. We’ll talk a little bit more about how to tell if the supplement is actually being useful to you a little bit later today.

But in general, if you have enough and you’re taking a supplement of that particular vitamin on top of already having enough stored, I would say it’s probably difficult to tell just because it’s not going to do anything. You wouldn’t notice a benefit or detriment of taking that particular supplement. Would you say that’s accurate, Laura?

Laura: Well, it depends on the type of the nutrient that you’re taking. Your gut can increase or decrease the transporters of certain micronutrients if it feels it needs more or less. But if it’s something that gets absorbed through the cell and not through transporters, an example would be a fat soluble vitamin, I don’t think your body has quite the level of control over absorption.

Kelsey: Mm hmm.

Laura: There’s different nutrients that if you’re in a deficient state, your body will up regulate the absorption capacity. I guess there’s lower risk of overdosing on something if it’s a nutrient that requires your body to up or down regulate the transporter proteins. But if it’s something that just kind of gets absorbed because of it being a fat soluble nutrient, then your risk of overdosing is a lot higher.

Kelsey: Right.

Laura: Which is why things like vitamin A, vitamin D you can kind of more easily overdose on because your body doesn’t have quite as much control over the absorption of that stuff.

Kelsey: Yeah, exactly. Other vitamins can also impact how well you absorb a particular vitamin. For example, your vitamin D status will affect how much calcium you’re absorbing. Or vitamin C, if you take that with an iron supplement. Let’s say you eat a bunch of strawberries when you take your iron supplement, you’re going to generally absorb more of that iron than you would otherwise. Those are just some examples. There are others of course, but those things you can pay attention to.

For example, if you’re working with a practitioner and you’re iron deficient, they may suggest that you take a vitamin C supplement with your iron supplement, or eat something high in vitamin C when you take your iron supplement, or avoid things like tea which inhibit iron absorption. There are certain things that can either help you absorb more of nutrient or actually decrease your absorption of it, which of course that’s going to depend on what your goal is. But a practitioner can help you kind of just basically guide you through those kind of interactions.

Laura: You talked a little bit about nutrients that increase absorption, but there’s also nutrients that either compete for absorption or can block the absorption. For example, calcium and iron will kind of affect each other’s absorption, so you wouldn’t want to be taking those products together.

Kelsey: Mm hmm.

Laura: It was kind of like what you said with the tea, the tannins in tea, which technically isn’t a nutrient, but there’s lots of things in food that can affect how well you absorb the nutrients. That’s one of the reasons for a lot of people…and I feel like, Kelsey, you’re on the same page here where a lot times you will try to get as much of the nutrients from food as opposed to supplementation because I feel like there’s less of that impact of absorption issues if you’re eating it as part of a meal.

Kelsey: Mm hmm.

Laura: Something like dairy and iron, when I think high iron foods whether or not you usually can consume lots of dairy with them, other than like a cheeseburger, I’m not really sure you’d be eating tons of dairy with red meat, that kind of thing. But I think that’s more of an issue when it comes to supplementation since it is just the isolated nutrient and it’s not really part of the food.

Kelsey: Definitely. Just as a general note here, I think like Laura just said, it’s certainly preferable at least in our eyes to get most of your nutrition from food. But there are definitely times when it makes sense to take a supplement. For example, I can think of one example for myself here is that I’ve got some thyroid issues going on now and I’m taking iodine and selenium mostly because I just know for me personally I’m not getting a lot of those nutrients in my everyday diet. I’d have to work really, really hard to include those more often to get enough and I may not even at that point be getting high enough amounts from my diet to really make a therapeutic difference on the thyroid issues that I’m dealing with.

There’s definitely times when a supplement makes sense. But as much as you can, and especially for like maintenance type of nutrition that we’re talking about or just making sure that you maintain a normal amount of a vitamin if you already have that normal amount, it can be totally fine to get it just from your diet. But if you’re starting off in a deficient state or you think you might be deficient, that’s when a supplement can be useful because again, you may just not be able to get the amount that you need to really increase your level of a particular vitamin though your food.

Laura: Mm hmm.

Kelsey: Let’s talk a little bit more about the leaky gut and SIBO that this person was asking about because like I mentioned before, those kinds of things can definitely impact the way that you’re absorbing vitamins and minerals. It definitely makes it harder in general I would say, but again, it doesn’t make it not worth it to take those supplements.

I kind of think about this in a cost/benefit ratio kind of way where if I know somebody is not getting enough of a particular vitamin or they’re deficient in a particular vitamin, just because they can’t absorb a supplement of that vitamin great right now doesn’t mean that I don’t want them to take it. Because again, going back to that idea that a supplement is going to have more than you need generally, taking that supplement and then paying attention to a few different factors to enhance the absorption of whatever vitamin we’re talking about, I still want them to do that because it’s better than getting nothing or getting just the small amount from food.

Laura: Right.

Kelsey: I get that question, but I really want you to think about it in cost/benefit ratio sort of way because to me that makes a whole lot more sense to just take whatever you can get basically and not worry about absorbing every last bit of everything that’s in that supplement.

Laura: It’s funny, I actually feel like the fact that SIBO or gut permeability could make absorption impaired actually is a reason to take the supplement, not to avoid it. I think that’s kind of what you were just saying where if you’re eating food and it’s not getting absorbed very well because you’re not digesting super well or the bacteria is kind of getting the nutrients before you get a chance to get it, then it’s almost like supplementation becomes more necessary because you’re not getting as much from the food.

Kelsey: Right.

Laura: Like you said, I don’t think you’re ever going to take a supplement where you get 100% of everything absorbed perfectly anyway, so the idea that that would even be possible even if your digesting is perfect is I don’t think a good way to think about the benefit of supplements. I would say the benefit of supplements is almost always to ensure adequate intake and utilization of that nutrient if your body needs more of it or is just not doing super well at absorbing it and that doesn’t really matter whether or not you have perfect digestion or not.

Kelsey: Right.

Laura: Because the only reason to take supplements is if you’re assuming you’re not getting from food you’re eating.

Kelsey: Exactly. I’d also say when it comes to digestive issues, that if you can take a liquid version or a powdered version, that may help your absorption a bit just because if you’re having digestive issues in the sense that maybe you’re not producing that digestive enzymes or something like that, if you’re taking it in a capsule format or if there are a lot of fillers or something that require you to have a pretty good digestive system to actually break that capsule down before you can even absorb what’s inside of it, you can take that piece out of the equation by taking it in a liquid or powered format.

That’s something to think about too if you do have a lot of digestive issues especially just in the sense of you feel like maybe food just kind of sits in your stomach, like you’re not really digesting really well or breaking things down very well. Maybe if you’re seeing pieces of food in your stool or something like that, those would be signs to me that it might make sense to be taking a digestive enzyme of course, but on the other hand when you’re taking supplements, taking out that piece of breaking it down first can be very helpful if you’re worried about absorption.

Laura: Mm hmm.

Kelsey: The other thing to think about here is really the stress management piece. I say that because that can have a really big effect on how well you’re breaking down food. Again, if you’re taking something in a capsule or tablet format, you do have to break that down first. If your digestive process isn’t working well, that’s going to inhibit what you can get from a supplement. In that sense, it makes a lot sense to really focus on stress management, especially around meal time.

What I like to do with a lot of my clients is have them sit down, do some deep breathing before they start eating. When you’re deep breathing with your food in front of you, you’re smelling your food, that’s stimulating the digestive enzyme release and production so that you can actually digest your food better and you’re kind of in that rest and digest mode rather than the fight and flight mode. That makes a lot of difference for many, many people and it’s so simple too. I find that honestly it makes a pretty big difference in a short amount of time. Even the first time somebody does that, they will report back to me that they really felt like they digested better. And it’s such a simple thing to include.

Laura: Mm hmm.

Kelsey: If you can add that at least at most of your meals, I think that can really go a long way even though it seems kind of silly and like it wouldn’t do much. I do think it can do a lot. Then it also makes your HPA axis more able to dive into rest and digest mode and able to do that more easily and more quickly in the future. You can kind of go back and forth a lot more easily between rest and digest and fight or flight when it’s necessary. I think a lot of us kind of get stuck in that fight or flight mode and it becomes difficult at a certain point to get into that rest and digest mode. The more you practice getting into that rest and digest mode, the easier it is for your body to kind of do that in the future.

That’s a really, really good tool to use to just make sure that you’re at least digesting as best as you possibly can given the conditions you’ve got going on. If you’ve got leaky gut, or if you’ve got SIBO, yeah we need to work on that, but in the meantime this is a really easy tool to use to help you digest as best as possible right now.

Laura: Yeah. It’s kind of funny, I’ve had some clients where they were complaining that they were having a lot of bloating and fullness after meals. I asked them, how long do you usually sit down to eat for when you’re having these meals? They’re like I don’t know, it maybe takes like 5 minutes or something. I’m like well let’s try to make this last more like 20 minutes. I’ll even have them set a timer and see if they can make the meal last 20 minutes. Which if you think about 20 minutes, it doesn’t sound that long for a meal. But when they actually go to do it, they’re like wow, I was already almost all done with the food before I even hit the 10 minute mark, so I definitely have to learn how slow down.

Kelsey: Right.

Laura: It’s amazing how much of a difference the speed at which you eat will affect your ability to digest a food. I’ve had some clients that it was basically like from one meal to the next where they went from feeling overly full and like they weren’t digesting to feeling fine with almost the same, if not the exact same amount of food.

Kelsey: Right. Along that line if you think about the way that we eat food and how we digest and absorb nutrients, it makes a lot more sense to take a least most of the type of supplements that you’re taking with food because that’s again when we’re in that rest and digest mode so our body is sort of primed to break down things at that point. You’re going to again, break down that capsule or that tablet a lot more easily than you would otherwise. Your body is kind of ready to absorb nutrients at that point because again, you’re in that rest and digest mode.

I think for most things unless it purposely says don’t take this with food you want to take it on an empty stomach, especially for things like vitamins, and minerals, and all that kind of stuff, it typically makes sense to take them when you’re eating, so with a meal. Then think about things like fat soluble vitamins. You want to take that with a meal and especially a fat heavy meal because that fat is going to help you absorb that nutrient.

You have to pay attention to those things because you want to think about how our body is meant to absorb nutrients. It’s meant to absorb nutrients when we’re sitting down to eat, we’re in rest and digest mode, we’re already absorbing things from our food. Adding a supplement that contains some extra vitamins and minerals, at least in my mind it makes a whole lot of sense that we’re going to generally absorb more of those nutrients than we would otherwise if we’re taking it on an empty stomach.

Those sort of things can really help you to absorb the supplements that you’re taking better. Definitely pay attention to what the label says or how your practitioner recommends that you take a supplement. In general, a vitamin and mineral supplements, you want to be taking that with food.

Laura: Mm hmm. Usually the bottles will say whether or not you should take it with a meal. Obviously if a practitioner has prescribed it and they’re telling you something different, then go with what they say. But if you’re just ordering something for yourself, then I feel like any of these good quality brands that are going to be sharing the instructions for the nutrient itself, they’re going to say whether or not you should take it with a meal, or outside a meal, or if there’s anything you should avoid while taking that supplement.

Kelsey: Yeah, exactly. Okay. I think from there, now that we sort of talked about how to really make sure that you’re absorbing as much as you can from the supplements you’re taking, I think it would make sense to talk about basically how you can tell if a supplement is doing anything for you. This goes back to the part of the question about the blood levels. Some of particular vitamins that you’re worried about, maybe those blood levels don’t really tell you a whole lot about how your body is actually utilizing that vitamin. The best thing to pay attention to in my mind is really your symptoms. If you have symptoms of a particular deficiency, then you start taking that vitamin or mineral, you can kind of pay attention to those symptoms and see if they get better.

Some examples of that would something like vitamin A, let’s say. If you have keratosis pilaris, or acne, or other skin issues, maybe night blindness, or just vision issues in general, those can be signs of vitamin A deficiency or just not having sufficiency of that vitamin I guess I should say. If you start taking vitamin A and you’re doing it with everything that we just talked about in mind, you’re taking it with meals, especially fat heavy meals, you’re resting and digesting, you’re really making sure your stress levels are low when you’re eating, all that kind of stuff, over the next few months pay attention to those symptoms. You can even keep a journal or anything like that to just help you track that and see over that amount of time, I’d say at least a month, if those symptoms get better. If they do, then to me that is evidence enough that you’re actually utilizing whatever extra vitamin that you’re getting because those symptoms are getting better.

Laura: Yeah. One other thing to consider with certain micronutrients and the impact they have on the symptoms is sometimes it’s a combination of nutrients that can be what shows the actual results. Vitamin A is a good example of a nutrient that a lot of people are deficient in. I feel like a lot of my clients are either not getting it in their diet or maybe they just can’t eat certain foods that have high levels of vitamin A. Vitamin A is a pretty common supplement that I would be recommending.

But the issue with vitamin A is that there’s other nutrients that affect how well it functions. An example of a nutrient that you need to allow vitamin A to do its job is zinc. If somebody is taking vitamin A on its own and they’re not seeing improvements in those symptoms, it’s possible that the benefit of vitamin A is being limited by a lack of another nutrient.

That’s where it can get a little hairy because there’s lots different micronutrients that will interact with each other. But just knowing that if you’re not seeing a benefit in the first month or two, it doesn’t necessarily mean the nutrient wasn’t necessary. It may just mean you’re missing another nutrient that is necessary to actually get the full benefit. That’s just something to keep in mind.

Again, kind of an area where working with someone who has expertise in the way that micronutrients interact with each other can be helpful because it’s not something that the average person is going to be able to figure out on their own. Certainly they wouldn’t necessarily know this nutrient isn’t working because I’m deficient in something else. B12 and folate are great examples of nutrients that if you’re just supplementing a lot of one, it can mask deficiency of the other.

There’s a handful of micronutrients that will have a good impact on symptoms if they’re taken with other nutrients that help them function. I just like people to keep that in mind and not necessarily just assume that say if they’re taking vitamin A for two months and nothing changes, that it meant that they didn’t need vitamin A. They may have needed it, but they might need other things as well.

Kelsey: Right. And like you said, I think working with a practitioner here makes a lot of sense and can make this a lot easier for many people because sometimes you won’t even know that some of the symptoms you’re experiencing in the first place are indicative of a particular deficiency. A good practitioner should be able to pick up on those clues and should know that some of things that you’re experiencing may mean that you are deficient in a particular vitamin or mineral, or things like that.

We talked about vitamin A, we talked about B12, folate. I guess we could actually jump into kind of the symptoms with B12 and folate which would be things like tingling or numbness, mood issues like anxiety or depression, problems with cognitive function so just feeling like you have brain fog can be something along those lines, or memory loss, or just issues with memory. And also fatigue when it comes to B12, especially B12 I’d say, but also folate as well. If you have any of those symptoms, that would a sign to look at B12 and/or folate as possible deficiencies that you may have.

Another example would be magnesium and electrolytes in that if you have things like muscle cramps or you’re waking up in the middle of the night with charlie horses, things like that. That can tell us that you may have low amounts or that you’re just not getting enough in your diet of magnesium and maybe some other electrolytes as well.

Let’s see, we can also talk about like I mentioned iodine and selenium for thyroid problems. For mine for example, it’s just a nodule. It’s not actually doing anything to the level of TSH or any of the other actual hormone levels. But if you do have issues with the hormone levels themselves, you may experience things like cold hands and feet, hair loss either from your head or on the outer edge of your eyebrows, things like water retention, low energy, weight gain, and dry skin.

Those are just some examples of the connection between vitamins and minerals and the symptoms that you would actually be experiencing. I mean there’s a ton of those and that’s where it can become really useful to work someone who’s very good at picking up on those hints that your body is giving you.

Laura: Yeah, I think because this person was saying they were concerned that blood levels don’t always give information about how nutrients are being used, the symptom side of things is really important because at the end of the day, we’re never going to know with 100% certainty that these products are actually getting absorbed and utilized. Using that symptom improvement method is going to actually show that your body is responding to the product in a positive way.

You had mentioned a few minutes ago that a symptom diary can be really helpful. This is something that either doing it on your own or working with someone who can kind of keep track of your symptoms over time can actually really help you recognize improvements in symptoms especially with certain symptoms that will take longer to see improvements in. Skin is a great example of one that can take a really long time to actually see the full benefit of something simply because it takes at least a month for the lower levels of your skin production to actually get to the surface. Anything that you change is really going to take at least a month to really fully show up at the surface of the skin.

It’s funny, sometimes…well I shouldn’t even say sometimes. It’s actually pretty frequent that I’ll be working with clients over the course of a couple months and I do a goal setting activity in the beginning of our session where we come up with the top three objective goals that we want to see improvements in over the course of our time together. At the end of the last session, we’ll talk about what their progress has been, if there is anything that has improved, hasn’t improved. It always kind of shocks me how often people just totally forget what the original issues were.

Kelsey: Mm hmm.

Laura: They get an improvement over the course of three months, and then it’s not until I remind them of what their original goals were and they’re like, oh yeah, I forgot that that was even an issue.

Kelsey: Right.

Laura: I think it’s totally normal once you start feeling better, you kind of forget how you were feeling before. It’s not like that’s unusual. I kind of laugh about it, but it is quite common and I’m sure I’ve been in that situation myself before.

That’s where the symptom diary can be really helpful because you can go back a couple months earlier and say okay, here’s what the main symptoms were that I was experiencing. Maybe take some photos if it’s something like a skin, or nail, or whatever physical symptom that you can and just be able to look back and say okay, do I actually have improvements? Is my skin better? How often am I having these muscle cramps at night? Are they even happening at all anymore?

Just knowing that you have seen improvement over the course of months is much easier if you’re writing it down. That’s something that is really helpful because if you’re not keeping track of things, you may just completely forgot that something was a problem and just assume that the supplement isn’t helping anymore.

Kelsey: Right, I know. I have the same experience with many, many of my clients as well. I think it’s just human nature to king of as soon as something resolves itself, totally forget about it.

Laura: Yeah, it’s like whenever I get sick I’m like I can’t wait until I feel better! I’ll never take that for granted. And then I’m better and I like totally forget that I was sick.

Kelsey: Right.

Laura: On the flip side of that though, it’s possible that with a symptom diary you may notice that you’re not actually having any benefit from that product. In that situation, it’s possible that the expense of the product isn’t worth what you’re spending on it. That can either be that you’re not seeing an improving at all, or you may actually be even having a worsening of symptoms after taking it. Or it’s possible that new symptoms have developed since you started the product. In that situation, you want to be keeping track of the changes so that you can stop the products that are causing you problems.

If you’re taking things that you’ve kind of done your own research on and just want to stop and see if that affects the reaction, then that’s fine. If it’s something that a healthcare practitioner has recommended to you, you should definitely talk to them about it before you stop it because they may have some insight into whether the reaction is normal or not because there are some products that could cause a worsening of symptoms before an improvement happens.

But you just don’t want to be taking something that is either not working at all or even causing new problems to come up that weren’t an issue before. I’ve actually seen that happen with certain clients where they did some reading on a specific product and thought that it would help them and it actually made things worse. Having these symptom diaries are going to be helpful for keeping things from either being a waste of money or actually causing worse problems.

Kelsey: Yeah, for sure.  I think the symptom diary is a well-used tool, but it’s something that people don’t do very often unfortunately. It’s something I really like to encourage my patients to do especially when it comes to not only supplements, but any sort of intervention that we’re trying whether that be supplementation or lifestyle changes that they’re working on. You want to really be able to track how those things change over time and a symptom diary is just really great easy way to do that.

Laura: Mm hmm. One last thing I want to add about whether or not the supplements have a good impact or not is consistency and compliance with recommendations. That’s something I’ve seen before with some clients where they don’t take the supplement as frequently as they’re needing to to actually see the benefit. It’s not super common. I think generally my clients are pretty well motivated and pretty consistent with the recommendations and it’s rare for me to work with someone who just blows off the guidelines or anything like that.

But just speaking in my own experience, I get kind of gung-ho about stuff in the beginning, and then I start forgetting, and I don’t take it as consistently. Then the question is okay, was that product not helpful? Or did I just not take it for the frequency or duration that it needed to actually have benefits? Just keep that in mind.

Kelsey: Right.

Laura: Just be honest with your compliance and look at what you’ve been doing and see okay, am I supposed to take this daily? Have I only been taking it like three times a week or something? In that situation you may not be able to get the benefit that you would get if you took it at the frequency and duration that you were supposed to.

Kelsey: Yeah, I’ve definitely had clients come to me and we’re going through their supplement history, and they’re telling me they took all these different supplements and nothing really worked. And then when I dive into that deeper with them ask them how long they took those things, very often the answer is a week or two. It’s because people like you said, they sort of get gung-ho about their supplementation and then after a week they’re like this isn’t really doing anything. Maybe they take it a few more times the next week and then by that point, they’re like eh, I really don’t notice a difference so what’s the point?

But like we’ve talked about before this episode, you do need to give things I’d say in general a good month of being consistent with it to really notice if something is changing. Like Laura mentioned before with things like skin issues, it can take even longer than that. It really pays off to be not only consistent, but also make sure you’re taking it for long enough and not just giving up immediately if within a week or two things aren’t seeming to change.

Laura: Which I’m definitely guilty of. I don’t necessarily give up on something, I just kind of start to forget.

Kelsey: Right.

Laura: The worst is especially if something starts to improve. Sometimes I’ll get issues with my skin. I think I’m prone to vitamin A deficiency, so I’m like I think I should be taking vitamin A. I’ll start to take it, and then the stuff will improve, and then I’ll just be like oh okay, and then forget to continue. It’s kind of like this little bit of a dumb cycle of forgetting to take it for a while, and then realizing my skin is starting to get worse again, and then starting it again.

Kelsey: Right.

Laura: I’m like the queen of inconsistency with supplements. This is something I definitely need to work on if I’m going to be taking stuff. But it can hard especially if you’re taking a lot of different of things. The more number of supplements that are on your list, the less likely it is that you’ll be consistent. That’s something that when I’m working with clients, I try to work on consolidation of things. I’ve worked with people before that were taking fifteen different supplements and I’m like we can probably find a pretty good multi that contains like eight of these and that way you’re only taking like half as many supplements.

Kelsey: Right.

Laura: I think there’s a lot of recommendations out there about individual nutrients that people will just overboard with the numbers of supplements and it just can get really difficult to keep that consistency.

Kelsey: For sure. Let’s jump into the second related question that this person asked which just to remind people was just about fraud in the supplement industry and how we can kind of know which brands of supplements contain they claim and are free of dangerous heavy metals that can just make things worse.

This is a really good question and I think probably the easiest way to answer this is to just say that you should use trusted brands. That can be kind of the first thing to look for. Instead of buying things at the pharmacy or the grocery store without really giving a lot of thought to the brand of supplement that you’re purchasing, I would recommend that you use brands like Thorne, or Designs For Health, Pure Encapsulations.

This is something that if you’re not super familiar with the supplement industry you may not know, and again a reason to potentially work with a healthcare practitioner who pays a lot of attention to that kind of stuff and works with supplements with many different clients over their course of their career. Laura and I spend a lot of time looking at the products that we recommend to our clients and we’ve kind of done the research that we feel comfortable with to recommend those brands to our clients.

If you’re just looking for a particular supplement because you want to take it and you have a choice of a few different brands, it can sometimes be difficult to know which one to choose. But I would say those three that I just mentioned, so Thorne, Designs For Health, and Pure Encapsulations, those are kind of my go to ones that I feel pretty comfortable across the board recommending. But even within those kinds of brands, you have to make sure that the supplement you’re recommending is appropriate for the client and that you’re using the right form of vitamin depending on what’s going on with that person as well.

There are definitely pharmacy or grocery store brands that will use poorly absorbed forms of certain vitamins. Just as a good example, think about B12. If you’re buying a cheaper version or a cheap supplement of B12, it might contain cyanocobalamin which is just not greatly absorbed, whereas some of the other higher quality supplement companies will use methylcobalamin. That’s certainly not across the board and they may make supplements within that brand some of which can include methylcobalamin and some which include cyanocobalamin. You still have to pay attention to that stuff despite still choosing those higher quality brands.

Laura: I may be wrong, but I think some of those forms impact your body’s ability to use them more than the actual absorption. I think there may be a few that don’t absorb quite as well, but for things like B12 I feel like it is more after it’s been absorbed what it does in the body than how well as your body can use it.

Kelsey: Right.

Laura: At the end of the day, we’re still talking about whether or not your body is getting anything out of the product that you’re taking.

Kelsey: Yeah.

Laura: But the absorption question I think does differ than the utilization question.

Kelsey: Yeah.

Laura: You had mentioned before that the form is going to be really important. There may be different clients that benefit from different forms where something like methycobalamin is great for a lot of people, but some of my clients actually don’t do well with methycobalamin.

Kelsey: Mm hmm.

Laura: That’s where working with someone who knows how the different forms of the nutrients can affect symptoms is really important.

Even these brands that we mentioned, like you said Thorne, Designs For Health, Pure Encapsulations, I think they’re trustworthy as far as the quality of the product, but they don’t always have the best blends of things. I’m not specifically pointing out any of those products or any of those brands in particular, but I know that I spend a lot of time going through the products that are available and choosing the exact products that I want to recommended to somebody. It’s not just like it’s Throne and their multi, I’m just going to use it.

Kelsey: Right.

Laura: I look at the exact ingredients and make decisions about okay, is this a product that I would generally recommend? And then also for the individual client, is it something that they should be taking?

Kelsey: Right.

Laura: Going with the specific brands is a good place to start to avoid toxicity issues or heavy metals, that kind of thing, but it’s not always the best way to determine the exact product you should be taking.

Kelsey: Yeah. I’d say they are also generally good for not having things like gluten, or dairy, soy. That’s not across the board with those supplements. I know that Pure Encapsulations I think in general is really good about that. I think they’re almost always gluten free, dairy free, and soy free.

Laura: I think they’re generally supposed to be a pretty hypoallergenic brand.

Kelsey: Yeah.

Laura: That’s their shtick.

Kelsey: Right. Basically I’d say most of those are going to be pretty good about not containing allergens like that. But it’s still something to look for just in general no matter what brand or product you’re choosing. Just make sure I would say at least it’s gluten free. Then depending on the supplement, there might be a little bit of soy if they’re using lecithin or there might be some dairy if it’s a probiotic for example. You don’t need to always need to get soy free, dairy free. But of course if you’re sensitive or allergic to any of those things, you want to just check and make sure that they’re not included.

Laura: I feel like these brands, that if they do include something, they’re pretty good at putting that information on the bottle.

Kelsey: Yeah, exactly. And then from there, you can look for some certifications. For example, there’s one called USP which is just an independent testing agency that looks at supplements to basically make sure that they don’t contain things that are harmful and they do contain what they say they contain. NSF is another one that is just a certification agency that looks at the manufacturing process of a supplement company and makes sure that it’s within their guidelines and their procedures for producing and manufacturing supplements.

Those things can help to just make sure that you are getting a good product that doesn’t contain something super harmful and it actually contains what it’s supposed to contain. But I wouldn’t say that if I saw those labels, I would 100% say that a supplement is good, and safe, and all of that. Like we’ve talked about, even within good brands that have these certifications, sometimes the particular form of a vitamin they’re using isn’t appropriate for a certain client or the blend of things that they have in a particular supplement doesn’t make sense. You still have to pay attention to that stuff. But just from a contamination perspective, I would say that those certifications are good look for.

Laura: This person specifically asked about heavy metals which is an interesting question because the USP and NSF certifications have certain levels of parts per million or parts per billion of different heavy metals that are allowed to be in products.

Kelsey: Mm hmm.

Laura: I think it’s the FDA that makes those guidelines about how much of those heavy metals are legally safe limits. But some of those levels that the FDA has set, some people argue that they’re a little loose and there are some specific types of products that by nature are going to have heavy metals in them.

I did a little research on the actual heavy metal question before we answered this question because I wanted to just know which products are the ones that are the ones to pay attention to. The products with the greatest risk for toxic metal contamination according to an article in the Integrative Medicine Journal, which I can link to in the show notes, are botanicals which those are basically herbs, or either single herbs, or herb combinations. That’s just because plants tend to take up heavy metals from the soil. Then minerals like calcium, magnesium, and anything derived from shellfish, so things like glucosamine and I can’t remember if it’s pronounced chitin?

Kelsey: I think it’s chitin, yeah.

Laura: Chitin? Okay.

Kelsey: But I don’t know for sure.

Laura: Yeah, some of these things like the shellfish ingredients, some of them I’m not totally sure why the product includes some of the stuff. But it’s either a filler, or if it’s something like glucosamine, there’s a need for that particular nutrient as part of the blend. Or if it’s like calcium from bone meal, there’s potential risk of lead just because of the way animal bones take up…it’s almost the same way plants will kind of store heavy metals, animal bones will as well.

Kelsey: Mm hmm.

Laura: Which in small amounts is obviously not that big of a deal, but it you’re taking lots of the product on a regular basis, then it can potentially kind of buildup overtime which is the main concern. One way to potentially scan for this is if a product says that it’s not allowed to be sold in California due to something called Proposition 65, then that means it probably has a little bit higher levels of heavy metals. It’s not to the point where it would be illegal, but it would technically be illegal in California. That Prop 65 limits, for example, lead to .5 micrograms per daily serving.

If you’re looking at a product that, even in you’re not in California, if it says that this product is not allowed to be sold in California, then that might be something to avoid if you are concerned about heavy metal toxicity. If you have been diagnosed with heavy metal issues or you just know that you don’t detoxify super well, then perhaps avoiding products that would not be allowed to be sold in California could be a good way to vet those out beyond those USP or NSF certifications.

Kelsey: Yeah.

Laura: That journal that I found this information in does have a supplement quality audit form that I’ll also link to in the show notes. They provide this audit that you can send to a manufacturer if you want to personally vet that company. If you’re very concerned about the quality of the product and you don’t feel like the information available on the website is putting you at ease about that product, then feel free to download that audit form and send it to the company. If the company returns it and you feel good about it, then go ahead and buy those products. If the company does not respond, then you may feel like you want to do your business elsewhere.

Kelsey: Yeah. In general, I’d say supplements can be a little bit confusing, but there certainly some things that you can do to make sure that the supplement makes sense for you. Then once you’re taking something, pay attention to your symptoms and see if things improve, if they stay the same, or if they get worse. That information will let you know if you should continue taking a supplement or not, or if it’s not worth your money to continue taking.

Then pay attention to those certifications, look at whether something can be sold in California or not. Often actually with the California thing, some supplement companies will actually make both versions. They make one that can be sold nationally and one that can only be sold in California. You can pay attention to that. If you have the option of buying the California version, I would say in general do that. Then like Laura mentioned, you can send that form to a manufacturer if you want to personally take a look at that company.

In general, I’d say working with a practitioner on supplementation even if you just do one consult with somebody to kind of go over what supplementation might sense for the symptoms you’re describing can be very useful just because a lot of you may not know what symptoms are related to certain deficiencies or not. You can definitely do some research on Google, just type in the symptoms that you have and maybe nutrients or something, add that to there and you might pull up some stuff that could be helpful. But in general, if you don’t want to spend your time during that or just don’t feel like you’re getting quality information doing it that way, working with someone can be very usual.

Laura: Great. Well hopefully that helps. I feel like we covered that in detail today.

Kelsey: Yes.

Laura: Good. Thanks for joining us everybody. We will look forward to having you with us next week. As always, if you want to submit a question, you can do so at TheAncestralRDs.com. Just go to the contact tab and submit your question that way and we’ll hopefully answer it on a future show. But otherwise, enjoy the rest of your week and we’ll see you here next time.

Kelsey: Alright. Take care, Laura.

Laura: You too, Kelsey.

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