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Almost one in every three Americans takes a multivitamin. But why? In many cases, nutrients from multivitamins are covered by a healthy daily diet. For some, vitamins and supplements are beneficial. But how do you know if you really need vitamin B, C or D? Or if fish oil or turmeric are right for you? Naturopathic doctor with UH Connor Whole Health, Dr. Jacob Wolf has the answers and helps you do your homework before buying a bottle of pills.
Pete Kenworthy
So, when I was growing up, a bunch of my friends were taking those Flintstone Vitamins, right? You remember those. I remember trying them, and they sure tasted good, but even then I thought, do I really need these? And now all these years later, I still wonder if I need vitamins. I mean, don’t we get what our bodies need from the quality food that we eat?
Macie Jepson
I wish, right? Because it’s no fun swallowing all of those pills. They’re expensive. I eventually shoved them aside in my cabinet because, frankly, I’m overwhelmed by what I have. And I really question whether or not they work.
Pete Kenworthy
All right, Macie, listen to this. The vitamin and supplement industry is on track to be a $200 billion industry this year. Let me repeat that: $200 billion this year alone. Now, with those stats, you think they’re working, right? Almost one in every three Americans takes a multivitamin.
Macie Jepson
And why not? If they increase our chances of being healthy, if they make us feel good. But this is what is always in the back of my mind. What do we really know about those supplements? That multi-billion dollar industry isn’t regulated by the FDA. Why not? I’ve always wondered that. And what is the science that proves vitamins and minerals and supplements do what they actually promise. Hi, Everybody. I’m Macie Jepson.
Pete Kenworthy
…and I’m Pete Kenworthy. And this is Healthy@UH. Macie, you and I debated doing this podcast for a while; for months, actually. I wasn’t sold on it, but then again, I don’t take vitamins, right? But then we started to hear from more people just like you, Macie, who said, they’re confused by choices. They don’t know if they’re buying the right thing, taking the right amount or getting what they need in their diets. So, here to answer our questions today, with science, is Dr. Jacob Wolf, a naturopathic doctor at University Hospitals Connor Whole Health in Cleveland. Thanks for being with us.
Jacob Wolf, ND
Thanks for having me.
Pete Kenworthy
So, let’s start with this. Can’t we get what we need from the food we eat if we are consuming healthy food?
Jacob Wolf, ND
Yes and no. If you’re consuming a good, healthy diet of lots and fruits and vegetables, whole grains, healthy fats, potentially. But our foodstuff that we eat nowadays isn’t the same as it was 50 years ago. So, there’s lots of issues even if you do eat healthy that you may not get every nutrient that you need.
Pete Kenworthy
Hmm.
Macie Jepson
So, they’re not as full of nutrition as they used to be. I did do a little bit of reading. Is that where you’re getting at?
Pete Kenworthy
Hmm.
Jacob Wolf, ND
Yeah. It’s very true. Our soil quality has changed. We’ve changed the types of foods that we grow. They’re not as much variety. We transport our food overseas. Stuff that isn’t in season year-round isn’t here in the winter. We don’t grow blueberries in Cleveland in February. And so, but you can get them at the store, and those are harvested early, not as fresh, not the right nutrient quality.
Macie Jepson
All right. So, we need to supplement our food to make up for that, right?
Jacob Wolf, ND
Correct. Yeah.
Macie Jepson
All right. But does everyone? And how do we know if we’re actually low on something? I mean, before running out and buying a bunch of vitamins, shouldn’t we do some type of test to find out what we’re low on?
Jacob Wolf, ND
Sure. There’s some testing that could be done. A lot of our standard annual labs look at some of that. So, we can get a good idea of iron status, vitamin D, calcium, some of our basic nutrients in just typical labs. A lot of nutrients aren’t tested routinely because they’re not standard labs. They just are things that if we had a health concern, your provider might dive in a little bit deeper, but on a general basis, they’re not tested for.
Macie Jepson
I’ve got so many questions. But let’s first talk about why we need nutrients in the first place. What’s going to happen to our body if we don’t have them?
Jacob Wolf, ND
You know, we’ll go back 100, 200 years, and we’d get a lot of those diseases like scurvy and rickets. And all these diseases are because of nutrient deficiency. And so, we still see people these days with these issues. People come in with scurvy, cause they’re not getting enough vitamin C, cause they’re eating only junk, processed food, all day, every day. And so, we still need to get all of these essential nutrients that you would find in something like a multivitamin in our diet.
Pete Kenworthy
So, what are the non-negotiables here? This kind of seems like where you’re going here. The ones that we must have sufficient levels of in our bodies and they are lacking in today’s food. Are there things like that?
Jacob Wolf, ND
If you’re eating a somewhat healthy diet, there’s nothing that you can’t get at a very basic level to prevent disease. You need 60 milligrams of vitamin C to prevent scurvy. You can get that in almost anything that you eat that is a fruit or a vegetable. But some people don’t eat fruits and vegetables, ever. And so that’s where we run into these problems. I would say there’s no supplement that anyone with a relatively broad diet needs to prevent those type of diseases.
Pete Kenworthy
Mmm. Are you implying that there’s something else that people who eat a relatively healthy diet would still need?
Jacob Wolf, ND
Yeah. Not getting scurvy is really far from optimal health.
Pete Kenworthy
Got it.
Jacob Wolf, ND
And so, there’s a whole wide range of supplements that may be desirable to optimize your health.
Pete Kenworthy
Got it. Before we go any further, I want to do some, just a little rapid fire here, right? Just ask you about certain vitamins, cause these seem to be the top ones, but kind of your take on them and really the science behind these.
Jacob Wolf, ND
Okay.
Pete Kenworthy
Okay? Does vitamin B really give you more energy?
Jacob Wolf, ND
For some people. B vitamins are heavily involved in our energy processes. They help with our adrenal glands. They help with the thyroid. So, for some people who are deficient, vitamin B or B complex can definitely help. And there are a number of B vitamins, not just one.
Pete Kenworthy
How do you know if you’re one of those people?
Jacob Wolf, ND
Some people, you know, B vitamins are relatively benign. So, at a kind of typical B complex level taking maybe one a day, we urinate out the excess. So, you can tell over a couple weeks, provided that you have no underlying health conditions, kind of what’s going on.
Pete Kenworthy
Makes sense. Does everyone living somewhere cold need to take vitamin D?
Jacob Wolf, ND
It’s not necessarily cold. It’s more the how far away we are from the equator. So, I started my practice in Phoenix, Arizona. Almost everyone there was vitamin D deficient. It’s sunny there all the time. We know that as we move further north, vitamin D deficiency increases. We see risk for a variety of different diseases. So, here in Cleveland with the winters that we have, with the clouds, most people need vitamin D. And we don’t make any vitamin D naturally between October and March in the Cleveland area. The sun’s not at the right angle and you just, you could lay out there naked all day, you’d get no vitamin D.
Pete Kenworthy
So, everyone needs it, but we aren’t getting it naturally? Or what is the risk of not getting it?
Jacob Wolf, ND
The biggest risk that we look at kind of clinically is bone health, but vitamin D works very differently than a lot of vitamins. It acts to turn on and off genetic expression in our body. It’s good for mood. It’s good for lots of different health things.
Pete Kenworthy
Will vitamin C or Zinc stop or shorten a cold?
Jacob Wolf, ND
The research is changing all the time. So, potentially Zinc, if you get it early enough, vitamin C may make you feel a little bit better, but it’s not going to necessarily stop progression.
Pete Kenworthy
A multivitamin is all that you need.
Jacob Wolf, ND
No. A healthy diet is really all that you need. A multivitamin is adding additional nutrition.
Pete Kenworthy
Fish oil.
Jacob Wolf, ND
Fish oil is a helpful nutrient. Again, it’s a ingredient that we don’t get a lot in our diet. It’s a healthy fatty acid. So, if you’re eating pizza and junk every day, you’re not going to get a lot of healthy fats in your diet. Fish oil becomes challenging because it’s one where there’s a lot of purity issues. So, you really want to know that they’re coming from a good company. You shouldn’t buy it by the gallon full, like a 600 pill jug of fish oil is a no go. It’s fish. It’s oil. It goes rancid. Keep it in your fridge. Get it in a small bottle. Buy it monthly.
Pete Kenworthy
Final one for you, turmeric.
Jacob Wolf, ND
Turmeric is great in theory. It’s just, it’s hard to get into the body. It’s not particularly well absorbed. You need certain other nutrients with turmeric to better absorb it. And so, it’s a complicated topic.
Pete Kenworthy
What’s it for?
Jacob Wolf, ND
Mostly for pain. It’s a natural anti-inflammatory.
Macie Jepson
See, that’s why I’m confused. I’ve got turmeric in my cabinet and I think it’s in something to make me sleep. See, it’s just…
Jacob Wolf, ND
Right.
Macie Jepson
It’s all over the place.
Jacob Wolf, ND
It’s a problem. We can discuss that, too. I spend a lot of time reading the label on the front of the ingredient and their overview of what it’s for and then looking at the ingredients, and more than half the time, it doesn’t even match up. So, just cause it’s marketing as a sleep supplement and you read the back and there’s turmeric and there’s something that’s totally unrelated, it doesn’t mean that they can’t sell it to you as a sleep supplement.
Macie Jepson
We’re going to talk a little bit about how these things work together and how you know that you’re getting what you buy. But I first want to talk about some of the things that you mentioned like vitamin D; does it need something else to get into your system? There seems to be a lot of combinations out there right now.
Jacob Wolf, ND
Yeah. There are a number of nutrients that are better absorbed with others. So, vitamin D works fairly well by itself and may be better absorbed and better utilized with other things like vitamin K2. But that’s not critical. We can get K2 as part of our diet as well with leafy greens. Vitamin D can be challenging to get just dietarily. Our main source is with dairy. So, many people are very sensitive to dairy, and so they avoid that whole class. There are other nutrients, magnesium and calcium tend to go together. They’re better absorbed when we have them in pairs. And there are lots. Vitamin C and iron work nicely together. It helps absorbability of iron if you have it with a vitamin C tab or with some citrus fruit. There are numbers of them.
Macie Jepson
Can you take too many?
Jacob Wolf, ND
Sure. I spend more time taking people off of supplements than putting people on supplements. I mean, in my opinion, a supplement should be supplementing something. You shouldn’t be sustaining yourself on supplements. You shouldn’t start your day saying, oh man, I have to swallow all these pills before breakfast or else I’m not going to exist today. Like that’s not how we work. And so, you can take too much. You can take bad combos. There’s lots of issues with over supplementation.
Macie Jepson
How do you know when you’re taking too much, though?
Jacob Wolf, ND
If you’re starting your day that way, like I mentioned, if you’re starting your day with a meal of pills and you can’t eat until lunch, then you’re taking too many.
Pete Kenworthy
Are there examples for too much vitamin A, C, D, K? Like, are there examples of what kind of impact it can have if you’re overdoing it?
Jacob Wolf, ND
Yeah. It’s different for each nutrient. So, it may be a little complicated to get into that. But there’s a group of nutrients that we need to be careful with. And those are the A, D, E and K. Those are the fat soluble nutrients. Many of the other vitamins are water soluble. So, if we get too many of them, we just urinate them out. But A, D, E and K accumulate in our body. We store them for longer. And so, it’s easier to get to toxic levels. Toxic levels of vitamin A, you get a severe headache. That’s the kind of acute overdose sign. And then there could be liver issues. Vitamin D is a little more behind the scenes, but you can accumulate too much and have too much of vitamin D. K causes, clotting. E causes bleeding.
Pete Kenworthy
Hmm. How do we know what we’re getting? Right? So, many of these bottles and things we can get in the store say natural, right? What does that mean?
Jacob Wolf, ND
Natural means nothing. It is a marketing term. So, natural, even in our kind of food world, natural means maybe at some point it came from some natural chemical, but it’s probably manufactured chemically now. In the supplement world, natural has no bearing. Organic, particularly for getting into supplements that have foods in them, food substances or herbs, organic may be a little bit better, a little bit higher quality. But all supplements should have some sort of purity statement, either on the bottle, on the company’s website. They should give you some sort of confidence that you are getting what they say is in the bottle. And there, the FDA even has a list of companies that are really bad, that they tend to put lots of junk and other things in their supplements that are not listed.
Pete Kenworthy
You say they should be on the bottle, but there’s nothing regulating them to put them on the bottle, right?
Jacob Wolf, ND
Right. Most supplements need to have a statement that says that it’s not FDA approved, cause supplements are not regulated through the FDA. But other than that, I think it’s up to the manufacturer to put some sort of marketing statement that attests to their quality and purity.
Pete Kenworthy
But you said even just a moment ago, when Macie was talking about her sleep medication, you flip around to the back and it says it has turmeric in it, which doesn’t make any sense.
Jacob Wolf, ND
Yeah. So…
Pete Kenworthy
So, you almost have to know what you’re looking for, and we don’t necessarily know what we’re looking for. Right? We decide we need vitamin D, so we buy it. We don’t turn it around and look at it. Right? It says vitamin D on the front.
Jacob Wolf, ND
Right. So, it should be vitamin D on the back. In most cases with vitamin D, it is. But many other supplements, no. Their marketing statement on the front does not match what’s on the back. And it’s a real challenge. Part of not being a regulated industry is that other than saying, this cures a disease, there’s a pretty wide range of what they can market on their bottle. And they know that if you are walking into the store and haven’t slept in three days, that you’ll pick up anything that says sleep on it, regardless of what the ingredients are. And so, some of that is, you know, marketing and selling products. And that’s why I try, in my office, to teach a lot of my patients about what’s a good quality product. What ingredients you look for. How do you read a label? What’s that kind of other ingredient section that’s all the fillers and binders and junk that’s completely unnecessary in most pills.
Macie Jepson
So, make sure that the front and the back match. Look for fillers and binders. What would they be looking for? What would a filler and binder look like on an ingredient list?
Jacob Wolf, ND
If your product is in a capsule, it may have something, it’s something to help to spread apart the ingredients as you swallow it and break down the capsule. But it shouldn’t have things like colorings and flavorings and scents, if it’s a, you know, maybe a topical product and it’s not intended to be scented. You can find sand. You can find talcum powder. You can find waxes. You can find gums. You can find all sorts of things in your products.
Pete Kenworthy
And you don’t need any of those, obviously.
Jacob Wolf, ND
They’re not medically beneficial for you. They’re just either trying to make the capsule prettier or alter the color or potentially help with that dispersal. But there are other ways to do that.
Macie Jepson
I just have to stay on this topic a little longer, because I feel like the general consumer or a lot of people wouldn’t know a marketing pitch on a bottle if it were right in front of them. So, I just want to dig a little deeper here. What are we looking for that’s going to be that red flag?
Jacob Wolf, ND
If you’re looking at a company’s website, and it doesn’t look like it’s advertising a product, it looks like it’s advertising a vacation somewhere, you know, it’s lots of pictures and graphics and no real content about the supplement, you know, I kind of do a basic sniff test. You know, if you’re going to a website for a supplement, it should at least say what the supplement is, give you an idea of what the ingredients are in dosing and where you can purchase it. If it doesn’t show that on the website, if I can’t find ingredients of a supplement for something that I’m trying to purchase, it’s a no go. If I have to dive 15 pages deep to find that, that’s all marketing behind that. And same thing goes, you know, for, for print advertisements or for TV advertisements. They’re paying for marketing. They’re trying to sell you a product, not necessarily benefit your health.
Macie Jepson
Complicated. And why doesn’t the FDA oversee this?
Jacob Wolf, ND
It’s really a challenge. You know, it’s not part of the FDA’s purview. Nutrients are not drugs. Herbs are not drugs. And so, unless it falls into one of those categories for treatment, it’s not part of their description of what they do.
Pete Kenworthy
However, you stated a moment ago that some of them could really do some damage if you use too much of them. Right?
Jacob Wolf, ND
Right. Yeah. It’s a challenge. If we started to get the FDA to regulate every supplement, they would, I mean, there’s so many of them on the market, they’d have to go ingredient by ingredient. Each ingredient would have to be tested, clinically trialed. There’s no way that they could accomplish that and do all of their other functions. So, it’s up to providers and, you know, research in that way to make sure patients are staying safe.
Pete Kenworthy
Fair enough.
Macie Jepson
In the meantime, there is a significant amount of science that backs what these vitamins and supplements do for our body.
Jacob Wolf, ND
There are for most. There are some ingredients that have less research. I would say, particularly when you get to some more fringe herbs that are in supplements, there’s less research. There’s not a lot of money for herbal research, although that’s growing. For most kind of mainstream nutrients, there’s research behind it.
Pete Kenworthy
I want to talk a little bit about preventing disease. So, couple questions here: what are antioxidants, and can vitamins and supplements really prevent or cure diseases?
Jacob Wolf, ND
So, antioxidants is a pretty easy one. Really, anything that you get from a fruit or a vegetable is an antioxidant. It’s all the colors, all the flavors, all the smells that you’re getting in a fruit and vegetable. And that’s the reason why we consume them largely is for that antioxidant benefit. So, kind of the powerhouses of the antioxidant world are things like berries, like colorful, flavorful, smelly. They are real potent, kind of scavengers in our body for damage and repair. And they’re important to the diet.
Pete Kenworthy
So, the second part of it is can vitamins and supplements really prevent or cure disease? But I’m not going to let you go on antioxidants just yet. You talk about how important they are, but we can also buy them, right? Can’t we buy things called antioxidants? And do we need those?
Jacob Wolf, ND
I would say, again, back to kind of our initial discussion, if you’re eating a relatively healthy diet, you’re getting antioxidants in the fruits and vegetables that you’re consuming. If you’re eating mostly junk and mostly processed foods, I would say, start eating fruits and vegetables long before I’d say buy a product that’s marketed as an antioxidant. There are some benefits to some of those products. You know, vitamin C is an antioxidant. There are lots of them out there that do that. But, again, supplements shouldn’t be sustaining you. They should be adding something and it comes after a healthy diet.
Pete Kenworthy
Okay. Back to the second part. Vitamins and supplements, preventing or curing diseases.
Jacob Wolf, ND
We kind of touched on this before. There are minimal amounts of nutrients that you need to prevent the majority of the diseases that we hear, things like, you know, pirates and older, you know, 1400s Europeans getting. We can get that from our diet now. Our diet is much more well-sourced than that. So, that’s kind of the disease prevented side. Supplements for curing get, unless there’s a severe deficiency, I wouldn’t use a supplement to cure someone of a disease. It may be part of a larger protocol. But it’s often coming with nutrient deficiency. If you have anemia and it’s due to low iron, then we have to replace iron. We can use an iron supplement or infusions, if necessary, if it’s severe enough anemia to correct that imbalance. And in a way that’s, you know, correcting a disease.
Macie Jepson
Can we end up reversing or making something worse? Say, I just want to have energy and I want to do B12, but uh-oh, now my blood pressure medicine doesn’t work.
Jacob Wolf, ND
When we’re talking about medications, it gets challenging. So, there are some nutrients that we know that someone might just pick up off the shelf. We’ll say St. John’s Wort is really common one for mood. St. John’s Wort essentially changes the way that your entire body processes medications. And so, St. John’s Wort affects the way that every single medication is absorbed. And so, that’s the number one, like, weird interaction it’s going to affect my medications no matter what I take. But there are plenty of other ones. We talked before about how some nutrients are better absorbed with others. Some nutrients block others from being absorbed. And so, the same thing can happen with your medication. You may find that a supplement that you’re taking that is intended to do good is going to raise the level of, let’s say, your cholesterol medication in your body. And so, it can cause side effects.
Pete Kenworthy
So, basically before you take something, talk to your doctor.
Jacob Wolf, ND
Talk to your doctor. Yeah.
Macie Jepson
Wow. We’ve covered a lot. This is really interesting.
Pete Kenworthy
Super cool. Yeah. I learned a lot.
Macie Jepson
Yeah. The thing is, is there are a lot of shiny promises out there in this field of supplements and vitamins and minerals. And it amazes me that people would just believe that, because you’re putting something into your body. So, final thoughts on that and how important it is to really do your homework.
Jacob Wolf, ND
It’s very important to do your homework. You should first know your kind of personal health status. So, if you haven’t had a check in with your physician, know what health conditions you may be needing to treat with your supplements first. But then do your homework. Read the ingredients on your label. Make sure they don’t interact with medications. Check with your provider, if you need to. Don’t take a thousand supplements. You know, a handful of things that could benefit your health are great, but don’t start your day with a meal worth of pills.
Macie Jepson
Sound advice. Thank you, Doctor, for being here.
Jacob Wolf, ND
Thank you for having me.
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