Do supplements work?

You may have noticed that we’ve recently begun to stock a range of Bioceuticals supplements that we feel are appropriate for our patient’s.
This is new for Osteohealth.
Why, after 12 years, are we now starting to stock supplements??
I’ve always had mixed feelings about supplements.
For a start- I am a shocking sceptic. I’m sceptical of nearly everything.
I’m also very logical. Cave men didn’t take supplements and they seemed to get on ok (although now I think about it, they only lived to their mid-30’s…).
I feel that if you are maintaining a healthy, balanced diet; don’t have any gut absorption issues; and exercise consistently, then they are entirely unnecessary.
They are also too easy. I hate solutions that only involve taking a pill. Disease and injury isn’t that simple. Tablets/surgery are not the only answer- they almost ALWAYS work better in conjunction with increased activity/exercise and lifestyle changes. Taking a tablet appears to remove people’s obligation to address the issue that created the problem in the first place.
I’m also incredibly sceptical of the data that is often presented around supplementation. The ‘science’ that is presented if often very poorly designed, poorly controlled and the studies are sponsored and paid for by the very companies whose products are being tested.
I’ve felt it’s like sports drinks (Powerade, Gatorade etc): a billion dollar industry created around the perception of having an effect, but in reality it does little more than create expensive wee!
A couple of things lately have caused a rethink:
  1. Attendance at a recent seminar given by an independent biochemist who discussed the relative merits of certain supplements and showed valid, independent studies.
  2. A request for us to stock supplements for patient use.
  3. Years of reports from patients about positive responses with supplements.
  4. My own recent, successful trial of certain supplements.
So what are supplements?
According to the Food and Drug Administration it is “…A dietary supplement is a product intended for ingestion that contains a “dietary ingredient” intended to add further nutritional value to (supplement) the diet. A “dietary ingredient” may be one, or any combination of the following substances: a vitamin, a mineral, a herb or other botanical…”
This is incredibly broad. So for the sake of today’s discussion, we’ll limit this to a couple of key supplements that we have access to and knowledge of, in physical therapies. In particular I’d like to address:
Fish Oil
Curcumin (a derivative of tumeric)
Uses: Proposed anti-arthritic effect.
Glucosamine has been around for decades now. I’m still conflicted with this. Various studies indicate that it can slow degeneration of joints, yet an equal amount show that there is no benefit whatsoever.
Tom’s verdict: It may be of some benefit to you; trial it for 12 weeks and see if it makes you feel better. If yes, continue using it. If no, don’t. We know that the greatest way to reduce the impact, and slow the rate of osteoarthritis/degeneration is to lose weight and maintain muscle strength.
So for possible improvements- use glucosamine.
For definite improvements- exercise and diet control!
Fish Oil (Omega 3 Fatty Acids- particularly DHA and EPA)
Uses: Proposed anti-inflammatory effect, reduce hypertension, reduce stroke risk, neural development, mental/cognitive issues.
Again- conflicting evidence around the benefits of fish oil. It does appear to have some benefit in the development of cardiovascular disease and a high fish diet has been proposed as the cause of reduced rates of stroke/heart attack in Japan and other fish dependent societies.
Omega 3 fatty acids are important in foetal development.
Tom’s verdict: possible benefits for cardiovascular and brain health but it MUST be good quality and have high levels of DHA and EPA or else it is pointless. This is a supplement I take as I don’t like fish! I believe Omega 3 fatty acids to be important and as I don’t get them from a dietary source I feel that I need to supplement this aspect of my diet.
Again- the best way to improve cardiovascular and mental health is EXERCISE. If you don’t eat much fish, then supplement. If you want to prevent heart attacks and strokes- exercise.
Uses: Reduce muscle tightness, pain, migraines, PMS, cramps.
This is close to my heart. I cramp – a lot. As an enthusiast cyclist it isn’t uncommon to ride hard for 3-4hrs. I’m almost certainly going to cramp.
Cramping is still VERY poorly understood. For years people have said it is due to dehydration and electrolyte status – and this is partly true. But it is physically impossible for me to sweat fast enough to become dehydrated in under an hour (in VERY extreme conditions 1.4l/hr is the max sweat rate but normally under 0.7 in hot conditions which isn’t enough to dehydrate people)- so why do I still cramp? Another theory is neural fatigue. Nerves get tired too and they stop inhibiting the muscle which makes is spasm (cramp). A combination of the two is probably likely.
Tom’s verdict:  I take Magnesium. I don’t know if I need it, I don’t know if it helps; but given the demands I place on my body I think it may so I’m willing to spend the money for potential benefit.
It needs to be a good quality Magnesium chelate so the body can absorb it and it may cause diarrhoea (so look out!). Start at low levels and gradually build to recommended levels.
Uses: Pain relief, anti-inflammatory, anti-oxidant.
Curcumin is great.
Anti-inflammatories are really important in our work where we are looking at acute injuries and lots of swelling. Voltaren, Celebrex, Nurofen all have significant side effects. Curcumin has less of these. Curcumin is very poorly absorbed across the gut so it needs to be delivered in a very particular way to be of use. Some curcumins are better than others.
Inflammation has also been implicated in heart disease, neurological disorders, respiratory disorders (asthma), gut issues (irritable bowel syndrome etc). Curcumin is gathering a reputation as a potent, natural way to assist in treatment of these.
Tom’s verdict: Curcumin is excellent for short term use to assist in breaking the cycle of pain and inflammation in injury. I’m not yet sold on long term use to prevent chronic disease states but I certainly haven’t written it off. I take Curcumin when injured.
Supplements are getting better. They are being made stronger and more bioaccessible (easy to absorb and therefore more effective). I have begun to take some regularly (fish oil and magnesium) because of my active lifestyle and because I don’t eat fish or other sources of Omega 3 fatty acids. I also know that they do no harm so the worst case scenario is expensive wee, not a damaged liver/kidneys etc.
I take curcumin when I have an injury for a period of 7-10 days.
I am also very particular about which brands I take. I see no point in consuming cheap supplements that cannot be absorbed into my body.
There are a couple of brands that are better than others. We chose Bioceuticals because they are one of these and we have access to practitioner only supplements that have higher doses and better absorption rates than the ones found on the shelf.
This is by no means a complete list but my take on 4 of the most common supplements in current, widespread use.
If you have any questions just ask your therapist and GP on their thoughts!
-Tom Barry