Many people wonder if their diet is balanced enough or if they may need some nutritional extras. “For vitamins and minerals, check with your doctor because he may have recommendations on ones he thinks are best,” said Cassie Weig, nurse and school health coordinator for the Lexington- Fayette County Health Department. Numerous factors are taken into consideration. “The doctor is aware of the (patient’s) history, what medications they are on and what allergies they have,” said Weig.

Many people take supplements. “The supplement industry is one that seems to have continued growth,” said Dr. Geza Bruckner, division director of clinical nutrition. “The sports supplement industry is probably the largest” said Bruckner. Just because a supplement may be commonly used does not make it safe. “For weight loss, a number of supplements have been pulled off the market and same with some of the cortisol-type compounds,” said Bruckner. This means you must proceed with caution. “The efficacy of most of the supplements that are out there has not been tested in any kind of controlled trial so that puts the safety in question,” said Bruckner.

The most important message is to have your doctor on board. “Metabolic supplements should be prescribed by a physician and the intake should be monitored,” said Bruckner. If used appropriately, you may find benefits. “Supplements have been an upper trend for the last several decades,” although having a balanced life in terms of diet of the full rainbow of vegetables and fruits, and reducing stress is really what they need, said Buckner. If a supplement is indicated for you, do your research. “Investigate the companies; USP is one of the classifications to look for to ensure the purity of the supplement because there have been several cases of contamination among supplementation with glass and fecal material being found,” said Dr. Travis Thomas, assistant professor in the division of clinical nutrition. There are also reports specific to the athletic supplements. “On a popular supplement, pertine powder, even though the label says it is pertine it may have other components or amino acids,” said Thomas.

Dieticians try to look at things from a food first standpoint rather than turning to supplementation. “Look at things like safety, efficacy and the cost benefit issue, which is huge with supplementation,” said Thomas. Weight loss supplements can have dangers. “A lot would fall in the category of stimulant-type supplements that could have major health risks associated,” said Thomas. Those looking to build muscle may have better options. “For body building, people may use creatine monohydrate or additional protein supplementation but there are a ton of different brands of protein powders, even though you still run into the issue of how safe it is as far as purity,” said Thomas. The key is to do your research as supplements are not hard to find. “They are found everywhere from grocery stores to the pharmacy and online,” said Thomas.

The American Thyroid Association states that the thyroid hormone is used to replace function of a failing or failed thyroid gland. For hypothyroidism, people need thyroid hormone replacement and pure synthetic thyroxine is taken once daily by mouth to treat symptoms, with the dose depending on weight, age and medical conditions, and adjusted based on hormone levels and symptoms. Other medical conditions may demand supplements. “For irritable bowel syndrome in some people, increase in dietary fiber helps because they are constipated and other times, fiber supplements can make it worse,” said Dr. Julie Swindler, bariatrician at Medical Bariatrics of Lexington. It is individualized. “For arthritis you have to make sure you are getting enough calcium supplements in your body and 1200 to 1500 milligrams a day is a good amount,” said Swindler. For osteoarthritis, make sure you get good B vitamins and fish oil may help, as well. “There is a supplement out there called glucosamine/chondroitin which is helpful with joints, as well to decrease inflammation and help you function better,” said Swindler.

Some supplements may be important as women age. “Doctors recommend women take a calcium supplement in addition to their dietary intake because of hormone changes they tend to develop osteoporosis or bone weaknesses,” said Lois Davis, public health nursing manager at the Lexington-Fayette County Health Department. Those with diabetes may use supplements including vitamins, minerals and herbs like cinnamon and St. John’s Wort. The American Diabetes Association states that supplements come in forms like tablets, capsules, powders, soft gels, gel caps and liquids and the main types are botanicals from plants and herbs, vitamins, minerals and fatty acids.

The American Diabetes Association cautions that you may think supplements are safe or mild because they are natural but side effects and drug interactions can occur. Examples are Aloe Vera, Fenugreek and Vanadium, which can cause excessive bleeding during surgery or interact with anesthetics. Ginseng can treat diabetes but may interfere with the drug Warfarin’s ability to prevent blood clotting. Trouble arises because people do not generally tell their doctor that they take supplements. Not having this discussion can lead to problems or even side effects that the doctor may attribute to another medication. Remember that retailers in health food stores do not have a medical background and are not familiar with your personal health so they cannot recommend products for you and the same applies to the internet.

Your conversation with your doctor should include any supplements you are taking, including multivitamins, and they should be listed in your records. He should know why you are taking them and if you stopped or intend to stop or plan to take a new one. You should find out how the supplement will affect your health, including blood pressure, blood glucose, cholesterol and other medical conditions. Know that the Food and Drug Administration does not regulate herbal products and alternative medicines and that supplements do not undergo the same stringent approval process as drugs. With this information in mind, be sure to be conscientious when making decisions regarding your health.

By Jamie Lober, Staff Writer