Tag Archive for: supplements

Creatine and the Unasked Question

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If you read the article on creatine posted by the AMA, while as short as a sentence or two, the points were valid. Let me elaborate on a couple of the ones I think are most important.

Creatine Builds More than Muscle

The point they were making is that creatine may be beneficial to build muscle in those over 65, but that’s not all. I checked the study on the relationship between creatine intake and memory in persons 66 to 76; while it’s a meta-analysis and those can be potentially biased in the way studies are chosen for inclusion in the analysis, the data showed that memory was improved compared to a younger population.

The question is why? My personal opinion is that creatine may increase the production of energy in nerve cells in the brain, which can help learning and memory. There’s also the possibility that creatine may help increase the fluid content of brain tissue, thus making the cells work more effectively; we do tend to dehydrate more as we get older.

The second important point was that creatine is safe to use for nearly all of us, provided we don’t have chronic kidney conditions. While there have been a few small studies that have shown that even in people with diabetes-related kidney failure, creatine can be safely used, it’s best to work with a physician/specialist if you’re in that category of kidney disease. They can check creatinine levels to make sure kidney function isn’t being harmed. For the rest of us, using 3 to 5 grams of creatine every day seems to increase the benefits of muscle repair and growth with weight training.

The slight water retention and digestive issues mentioned are minor issues that typically resolve themselves when compared to the benefits creatine may generate. Just remind yourself that if your brain is retaining a little water, that’s a good thing!

The Unasked Question

What’s the question no one ever asks in nutrition studies? “How did you feel while you were taking the supplement?” Feelings can vary depending on the supplement: more energy, better sleep, fewer digestive issues, and on and on. I’m not talking about filling out questionnaires or taking tests. We’re all grown up enough to know that you may feel a little worse at first, but it usually goes away with time, so don’t get in a hurry to give up on creatine.

Simply, “How did you feel?” At the end of the day, that’s what’s really important to the person taking the supplement. Too often, because there are no real “hard science” tests for how a person feels, it’s not asked. We simply don’t know everything about how every food, every supplement, and every pharmaceutical impacts every tissue in every organ in the body. Sometimes, it’s just about how you feel day in, day out.

What are you prepared to do today?

        Dr. Chet

References:
1. https://www.ama-assn.org/public-health/prevention-wellness/9-things-patients-should-know-about-taking-creatine
2. Nutr Rev. 2023 Mar 10;81(4):416-427. doi: 10.1093/nutrit/nuac064.

The AMA and Creatine

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After last week, you may be thinking I’m going to talk about another healthcare professional dissing supplements. I’m very pleased to say that’s not correct this time around. You can read the article by clicking here; I wouldn’t recommend listening to the audio version—seems like an AI voice to me.

The first thing that blew me away was the sponsorship: the American Medical Association. I’m not used to the AMA even acknowledging supplements exist except to caution patients to be very cautious using them. Great change.

According to the title, there are nine facts patients should know about creatine. I think the first was the most important: taking creatine in conjunction with a weight training program will increase muscle mass over time. I agree completely. The age range goes from 20 to 80; for people over 40 and facing a continual decline in muscle mass over time, that’s important information to know.

I’ll cover the rest on Saturday, including the question never asked in many studies on dietary supplements.

What are you prepared to do today?

        Dr. Chet

Reference: https://www.ama-assn.org/public-health/prevention-wellness/9-things-patients-should-know-about-taking-creatine

Questionable Comments on Dietary Supplements

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I hope you had a chance to read the article I referred you to on Tuesday; you can still read it by clicking on this link. For the record, I’m not a fan of the AG1 product. In my opinion, supplements should not mix herbals from medicinal plants with vitamins, minerals, and phytochemicals. That aside, there are three main points I alluded to in Tuesday’s Memo so let’s take a look.

Pharmaceuticals vs. Supplements

First, dietary supplements are regulated by the FDA, just not in the same way as pharmaceuticals. Here’s the difference:

  • Medicines have to prove they are safe before they are released for use by the public, but they can claim they will prevent, treat, or cure diseases.
  • Supplements cannot make such claims; they can make only structure-function claims: “This product may help digestive health,” for instance.

This “fact” as the writer proclaimed is the mantra of the American Medical Association and FDA. It seems worse now that they’re producing videos together for the general public. There’s a lot more arguments here, but that’s for another time.

So Much Beta-Carotene

The author brought up the beta-carotene and smoking studies, but I don’t understand why he didn’t question the amount of beta-carotene used in either study. The studies used four to six times the actual intake of beta-carotene at that time. These made these studies suspect because of the extreme use of beta-carotene in the studies. That’s what should be questioned.

Inadequate Nutrition

The proof was poor that he used to suggest that over 75% of the adult population get adequate vitamins and minerals from the food they eat. It was a study based on data collected via food-frequency questionnaire from specific segments of the Hawaiian and Asian populations in the mid 1990s, and I think we all know that those diets differ from the typical diet on the U.S. mainland or Europe. There are data from the 2021-2023 NHANES study available. It’s difficult to compare the data because of the way they were analyzed in the prior study, but a look at the nutrient intake from food looks more like we get 66% of the RDA, at least for some nutrients such as vitamin A, and worse for other nutrients.

Are there more problems? Yes, but that’s enough. This was a rehash of old arguments to say supplements are not necessary. But there’s one question that no one ever asks in any studies. I’ll leave you in suspense until next week when we look at what one physician said about creatine. I think you’ll be surprised.

What are you prepared to do today?

        Dr. Chet

Let’s Talk About Dietary Supplements

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I’m in a constant state of frustration over comments about the use of dietary supplements. Not by gurus and influencers; I don’t expect much from them except promotion of specific products for monetary gain. I mean the people with the credentials, with the scientific background, who say things that are simply not accurate. They seem to become bolder every time they punch letters on a keyboard. In the next four Memos, I’m going to provide you with a link to read what I’m talking about along with an overview of what stood out to me. On Saturday, I’ll give you reasons behind my frustration. But it’s not all bad.

The first was an article from one of the writers at McGill University’s Office for Science and Society. This is a well credentialed university department with this mandate: “to demystify science for the public and separate sense from nonsense.”  They go on to say they have a history of tackling fake news in the world of science well before the term “fake news” even existed. They cover everything with science behind it including diet, nutrition, and medicine.

In this article, the writer went off on a specific product you may have heard about called AG1 powder back in March of 2024. The premise of the article is that vitamins, minerals, and herbs are not necessary in the first place and certainly a not a green powder that has 75 ingredients in it. But in his criticism, the author says at least three things that are not accurate. He cites the beta carotene and smokers study, studies on vitamin K and anticoagulants, and that dietary supplements are not regulated in the US! I’ll give you my thoughts on Saturday. The link to that article is below.

What are you prepared to do today?

        Dr. Chet

Reference: https://www.mcgill.ca/oss/article/critical-thinking-health-and-nutrition/you-probably-dont-need-green-ag1-smoothie

Three Tips for a Healthier Year

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Most people look at the New Year as a time to make some changes to eating and exercise habits to accomplish health goals. For many, it’s reducing their body weight; for others, it’s getting fitter. But health is more than body weight and fitness. Many of us want to improve our diets, lower our blood pressure or cholesterol, become more flexible, or

take better care of our teeth, and for some, managing pain and other health conditions is a goal. Here are three tips to help you become healthier by the end of the year.

Tip 1: Use Available Technology

In a blog from the business builder Seth Godin about using technology, the final line was, “Working harder is rarely a better plan than finding better tools.” The quote was related to business, but it applies to health as well. Sometimes the tool is information; I hope that’s one of the reasons you read the Memo. I’ll have a lot more info coming to help you get healthy in 2024 from webinars, courses, and maybe some live events.

Sometimes, the tool is a device like a smart watch or a specific type of monitoring technology. I recently got a Kardia ECG monitor to collect data on my ECG. With other tools, you can monitor your blood pressure, oxygen level, and blood sugar to determine your patterns. But you must master the use of that technology for it to be helpful. The same is true for any exercise equipment you choose to use. That leads to the second tip.

Tip 2: Know Why You’re Doing What You’re Doing

If you’ve ever heard me speak in a seminar, I always tell people when it comes to taking a dietary supplement, you should know exactly why you’re taking it. Some are non-specific for overall health like a multivitamin-multimineral, but you may be taking a supplement for a specific reason, such as taking ginkgo biloba for increasing blood flow or coenzyme Q10 for more energy. You should know the reason for anything you’re taking.

This is my addition for 2024: you should also know why you’re taking every medication you’re taking. Have a thorough discussion with your physician or your specialist to determine why you’re taking each medication, what its purpose is, and whether you’re taking the lowest dose to get a positive effect. And then you must be able to test that impact somehow. Either you’ll have less pain, more flexibility, lower cholesterol or blood pressure, or some measurable benefit, or it’s time to change things.

You could apply that to foods and exercise as well, but supplements and medications are usually more purposeful.

Tip 3: Be Consistent

It seems I’ve talked about this forever, but you must try a change in lifestyle for at least 90 days to know if it works. You have to be consistent and track the health benefit somehow. Weight and blood pressure are easy; I still use a small notebook to track calories as I work to get to a normal body weight. For pain and digestive symptoms, you can find pain and symptom scales; this pain scale is on drchet.com. Then find a way to record the results every day—electronically on your computer or smart phone, or pencil and paper. I track workouts and total calories on an Excel spreadsheet; Paula has recorded her weight in a paper calendar most of her life.

You have to be able to go back and see any changes or patterns. How will you know you get fewer migraines if you aren’t tracking each one you get? That applies to every change you’re making.

If you can use these three tips, your 2024 will be less frustrating. Not everything works for everybody, but there’s always another approach. If one doesn’t work, go to the next. As long as you pay attention, you’ll finish the year healthier than when you began.

What are you prepared to do today?

        Dr. Chet

Dietary Supplements: Certified

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Recently I watched a webinar on mitochondrial health and athletic performance co-sponsored by the American College of Sports Medicine and a nutritional company. The speakers were a clinical researcher and a PhD dietitian for a professional basketball team. I’m going to review what the clinical researcher talked about on Saturday.

Today I’m going to focus on a comment by the dietary specialist. She believes as I do that supplements complement a good diet, but when she started talking about dietary supplements, she said they aren’t regulated by the Food and Drug Administration. At that point, I would typically stop listening because she’s incorrect; both the FDA and the FTC regulate dietary supplements; it’s just done in a different way than over-the-counter medications and pharmaceuticals.

Then she said that whatever supplements she recommends to her players, she looks for products that are certified by NSF or the United States Pharmacopeia (USP). I agree. These are not easy certifications to obtain. It isn’t just that the supplement is tested once and it’s over—it’s an ongoing process that costs a lot of money for the company, but they’re industry standards. Certification is something you should consider when you purchase dietary supplements of any type but especially related to sport performance.

What are you prepared to do today?

        Dr. Chet

Teaching Doctors About Supplements, But Not Really

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If you haven’t watched the videos that I talked about Tuesday, please take the time to watch them, preferably before you continue reading—I’d like you to form your own opinion about the videos before you get my perspective. I came away with three opinions about the videos, other than they really focused on dietary supplements not being approved by the FDA. Of course, no legitimate healthcare professional or supplement manufacturer ever said they were; consumers may not know that, but I would hope doctors did.

First, the second video discussed potential drug-supplement interactions. There have been few direct studies on those interactions; most are case studies involving the use of herbs such as St. John’s wort and ginkgo biloba that have been published in peer-reviewed journals. What they don’t say is that very few studies have examined drug-drug interactions either. How do they find out about them? Trial and error from reports to the FDA’s adverse effects reporting system.

That addresses my second opinion. There was a strong focus on reporting adverse events from dietary supplements to the FDA. One would think that’s a good thing, but the list of adverse events they listed included every system in the body. I get reporting an allergic reaction, but how would a physician attribute gastrointestinal or cardiovascular issues to a dietary supplement after putting the person on a new medication? It’s just as likely to be due to the medication. Seems to me like an open door to lots of irrelevant reports.

Finally, they spoke about some supplements interacting with blood tests. The only one I’m aware of is excessive biotin intake affecting the troponin test for potential cardiac events. One would expect an extensive list would be provided; the problem is none exists because that’s the only known interaction.

The Bottom Line

There are 13 vitamins. There are dozens of minerals, most found in trace amounts. There are hundreds of herbs, plus nutrients that don’t fall into any of those categories. All can be found in dietary supplements. If I were a physician who spent time watching the videos, I really wouldn’t know more about those nutrients in supplements than I did before I watched. I would have learned only two things:

  • The FDA does not have the authority to approve dietary supplements.
  • If a patient takes dietary supplements, anything bad that happens in the body should be reported as an adverse event.

A lot of red flags were waved when the issues deserved a yellow flag at most. I can think of only one word: sad. With the lack of training and knowledge about supplements among doctors, I think those two organizations could have spent their money better and created videos that would have really helped doctors and their patients.

What are you prepared to do today?

        Dr. Chet

References:
1. https://www.youtube.com/watch?v=GYJYPCJmspE
2. https://www.youtube.com/watch?v=qqyP-vbtlZY

Teaching Doctors About Supplements

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In late May, the Food and Drug Administration (FDA) in partnership with the American Medical Association (AMA) released two short videos to teach physicians about dietary supplements, plus a third aimed at consumers.

The first video spent time defining and explaining what a dietary supplement is, the delivery systems companies use such as tablets,  gummies, bars, etc., and the role the FDA plays in the process. The second video focused on adverse events, how to report them, and a sample conversation between a doctor and patient. I encourage you to watch the videos at the links below.

I think there are two important points of the videos. First, the FDA does not approve dietary supplements in the same way that they approve pharmaceuticals—obviously their main point because it was repeated several times. In exchange for allowing supplements to be introduced quickly, companies do not have to prove safety or effectiveness. However, if they make any health claim, they must report that to the FDA within 30 days of making the claim. Those claims are restrictive; a company can’t say on the bottle or promotional materials “cures heart disease” but can say “contributes to a healthy heart.”

Second, you should always discuss the supplements you take with your physician, especially if you take medications. It can be a pain if you take a lot of supplements, but you must do it because there can be interactions. For example, calcium, whether from food or a supplement, interferes with the absorption of thyroid medications. They should not be taken together (which is tricky because it’s recommended thyroid meds be taken at bedtime when you may be taking a calcium-magnesium supplement to aid sleep).

Those are what I see as the positives of these videos that cover supplement companies and patients; there’s no information about how supplements work or which supplements do what. I’ll cover that aspect of the videos on Saturday. In the meantime, take the time to watch both 10-minute videos.

What are you prepared to do today?

        Dr. Chet

References:
1. https://www.youtube.com/watch?v=GYJYPCJmspE
2. https://www.youtube.com/watch?v=qqyP-vbtlZY

The Supplementation Sweet Spot, Part Two

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We’ve got the beginning of our sweet spot for supplementation started with a multivitamin-multimineral and probiotics; today I’ll finish it up with two more—depending.

Omega-3 Fatty Acids

Recommendations on the type of omega-3s seem to be in flux with disagreements over docosahexaenoic acid (DHA). The cause for concern seems to be the potential relationship between DHA and atrial fibrillation. I’m still not satisfied as to the relevancy of the risk in the general population with one exception: those people who’ve had myocardial infarctions (heart attacks) that resulted in the loss of heart muscle. For now, those people may want to be cautious. My research continues and when I have an answer, so will you.

Unless you regularly eat servings of cold-water fish two or three times a week, part of your foundation supplementation should be 1–3 grams of EPA, DHA, or the plant-sourced alpha linoleic acid (ALA), or a combination of all three. You can pick any body system, and omega-3s are most likely beneficial. This is especially true of the cardiovascular and nervous systems.

Vitamin D

The final foundation supplement that makes up our sweet spot is vitamin D but with a catch. Instead of taking massive amounts of vitamin D, the best way to determine whether you need to supplement with vitamin D is to get your blood levels checked via a 25 hydroxyvitamin D (25(OH)D) blood test. If you’re low in vitamin D, below 30 ng/mL, add more vitamin D to your supplements in 50 mcg (2,000 IU) increments until your blood level reaches 40–60 ng/mL. Obviously, you need to see your doctor for the test, but you should be seeing your doctor regularly anyway.

Depending on where you live, sunlight will help you maintain healthy vitamin D levels with about 15 minutes exposure per day. However, in Northern areas such as here in Grand Rapids, that only happens about half the year, so we make sure to take our vitamin D supplement and bump it up a little in winter.

More

Vitamin D has become controversial with the current COVID-19 outbreak. Vitamin D will not prevent you from catching COVID-19; it will help reduce the severity of symptoms. But megadosing on vitamin D can have consequences that can result in bone loss. That’s why basing your intake on a blood test is the right way to go.

The Bottom Line

There you have the sweet spot for foundation supplements that all of us need, regardless of the quality of our diet. What about all those other supplements out there? Fine tuning supplementation to meet your personal needs is where supplements get complicated and need to be personalized. With the billions of dollars spent on supplements every year, if everyone began with the sweet spot of foundation nutrients, everyone would be better off, just like the sweet spots for diet and exercise.

If you want to know more about the science behind these supplements as well as how to assess a quality manufacturer, get a digital copy of Supplementing Your Diet; if you want to pass along the information to others, get a 5-pack of CDs at reduced prices. They’re all on sale at 25% off, and that’s in addition to Member and Insider discounts. You can also find info on supplementation for other conditions such as high blood pressure, pregnancy, migraines, weight loss, and more at the Store at drchet.com.

What are you prepared to do today?

        Dr. Chet

Identifying the Supplementation Sweet Spot

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I believe everyone should add a foundation of supplements to their diet, but there’s no reason to take supplements you don’t need. The last two weeks, I’ve written about the sweet spot for nutrition and exercise as I see it, so it just seems logical to do the same thing for dietary supplements. While supplementation can be very complex, there’s a foundation where we all begin. To me, that’s the sweet spot.

It all begins with a multivitamin-multimineral. With the gaps we have in our diet and with research confirming the gaps, that’s where we should start, but how to choose? Your ideal daily multivitamin-multimineral would have at least the recommended dietary allowance (RDA) for all the major vitamins and minerals. It should also have a blend of dehydrated plant material to provide the phytonutrients we’d get in plants if we ate them. That’s it. Too many brands on the market throw in herbs for men’s health or women’s health. Not everyone needs them, so why put them in a foundation supplement?

The second nutrient is actually not a nutrient; it’s probiotics. If we don’t eat enough raw or fermented foods, we’re not adding to our microbiome; adding a probiotic supplement will help build a stronger, more effective microbiome. Does the number of strains matter? No, but it’s better with strains shown by research to be beneficial. Do the colony forming units (CFUs) matter? Again, no. What does matter is whether it contains a prebiotic or not, typically a fiber such as inulin. Because our diets are poor in this food source, purchase one that contains prebiotics.

Those two supplements are the foundation of nutrition for people of every age and condition; there are two more that most people probably need, and we’ll talk about those on Saturday. If you’re interested in more of the science behind my choices, pick up a copy of Supplementing Your Diet as either a download for yourself or the CDs to share with others. They’re all on sale at 25% off, and that’s in addition to Member and Insider discounts.

What are you prepared to do today?

        Dr. Chet