I know from my practice that individualised advice on diet, lifestyle and good quality supplements is highly effective, and side effects are rare.

The public needs education on which supplements to take, as do doctors. Unfortunately, trials on supplements are usually carried out with poor quality supplements, at wrong doses, by doctors who know little about how to use them. Synthetic vitamin E is used, which contains only one of the 8 forms of vitamin E, plus its mirror image. These block the receptors, so that the other important 7 forms cannot dock. Similarly, synthetic beta carotene is used, which blocks other important carotenoids, like zeaxanthin, lutein and lycopene.

Some studies used toxic doses of vitamin A. Of course that killed people. Vitamin A needs to be kept safe by retinol binding protein, and there is not enough of that to cope with huge doses.

A mistake doctors carrying out studies make is to ignore how much people already take in with their food. For example, people already taking in more calcium they need in their food are given huge doses of additional calcium. Naturally it is deposited in arteries.

Another mistake is to give one nutrient alone, when biochemistry demands teamwork. If we are interested in bone health, vitamin D helps with calcium absorption, and magnesium and vitamin K2 make sure the calcium is put into bone, not into arteries.

The European Union tries to regulate supplements, but does it most incompetently. For example, they banned the safe form of chromium, chromium polynicotinate, and force people to use the toxic form, chromium picolinate. They say that molybdenum and glycine are safe, but banned molybdenum glycinate, a well absorbed form.

Undoubtedly there are many cheap supplements with too low doses to be effective, and with nasty ingredients like carrageenan and aspartame.

Drugs have caused terrible harm, from Thalidomide to Vioxx, and from statins to antidepressants. Drugs tend to have side effects, that lead to prescription of drugs to deal with the side effects, and more drugs to deal with the side effects of those drugs. This leads to dangerous polypharmacy. No one can work out how multiple drugs interact. Supplements have a much better safety record. This would be even better, if we had better education in nutrition for doctors and the general public.

Older adults need more calcium and vitamin D to help maintain bone health. Have three servings of calcium-rich foods and beverages each day but for young or adults its not necessary at all. depends on conditions.

I think nowadays this a bad trend to make money with advertising dietary supplement for sale.

This trade don't care about health at all... like mafia's of sugar!!!

Dear we should promote natural products rather than dietary supplements.

I know from my practice that individualised advice on diet, lifestyle and good quality supplements is highly effective, and side effects are rare.

The public needs education on which supplements to take, as do doctors. Unfortunately, trials on supplements are usually carried out with poor quality supplements, at wrong doses, by doctors who know little about how to use them. Synthetic vitamin E is used, which contains only one of the 8 forms of vitamin E, plus its mirror image. These block the receptors, so that the other important 7 forms cannot dock. Similarly, synthetic beta carotene is used, which blocks other important carotenoids, like zeaxanthin, lutein and lycopene.

Some studies used toxic doses of vitamin A. Of course that killed people. Vitamin A needs to be kept safe by retinol binding protein, and there is not enough of that to cope with huge doses.

A mistake doctors carrying out studies make is to ignore how much people already take in with their food. For example, people already taking in more calcium they need in their food are given huge doses of additional calcium. Naturally it is deposited in arteries.

Another mistake is to give one nutrient alone, when biochemistry demands teamwork. If we are interested in bone health, vitamin D helps with calcium absorption, and magnesium and vitamin K2 make sure the calcium is put into bone, not into arteries.

The European Union tries to regulate supplements, but does it most incompetently. For example, they banned the safe form of chromium, chromium polynicotinate, and force people to use the toxic form, chromium picolinate. They say that molybdenum and glycine are safe, but banned molybdenum glycinate, a well absorbed form.

Undoubtedly there are many cheap supplements with too low doses to be effective, and with nasty ingredients like carrageenan and aspartame.

Drugs have caused terrible harm, from Thalidomide to Vioxx, and from statins to antidepressants. Drugs tend to have side effects, that lead to prescription of drugs to deal with the side effects, and more drugs to deal with the side effects of those drugs. This leads to dangerous polypharmacy. No one can work out how multiple drugs interact. Supplements have a much better safety record. This would be even better, if we had better education in nutrition for doctors and the general public.

I want to start from a quote of the father of Toxicology;

Paracelsus (1493–1541), the father of toxicology, once wrote: "Everything is poison, there is poison in everything. Only the dose makes a thing not a poison".

Then, we should go by the advice of Emmanuel Ifeanyi Obeagu above.

I think we should beware of supplement at all time. It is advisable that balanced nutrition will care for all reasons behind supplementation.

For instance, constant Vit C supplementation have been reported in iron overload leading to another problem, hemochromatosis.

Similarly, vitamin C megadose have been repeatedly reported to trigger cataract aside from its therapeutic benefit.

And many more and more.

Article High-dose Vitamin C: A Risk for Persons with High Iron Stores?

It is often claimed that a good diet is enough, without supplements. This ignores our diversity. What is enough for one person is not enough for another. Also, many people are not on a good diet, whether from lack of money, lack of availability, or addiction to harmful foods like sugar.

We evolved without air pollution, water pollution, electromagnetic pollution, legal and illegal drugs, and mercury containing fillings and vaccines. We didn't drink milk. We didn't consume much fructose. We live in a different world, and our nutritional requirements have changed. We also hope to live long healthy lives. Could our ancestors aspire to that?

Our ancestors lived in Africa. Now some of us live far from the Equator. Our ancestors spent a lot of time outside. Many of us have jobs requiring spending hours indoors. We do not receive the vitamin D our ancestors did.

Deaths from drugs are many, and are one of the main causes of death in the richer countries. Deaths from supplements are few, and often due to doctors, who give overdoses of vitamin A and calcium. In many countries, nutrition is neglected at medical school.

If you have asthma, do you take magnesium and fish oil, or a drug that increases the risk of death? Asthma was regarded as a benign disease, before the drugs came along. Do you take magnesium to reduce clotting, or vitamin K2 to remove calcium from your arteries, if you have coronary heart disease? Or do you choose a statin, which increases the risk of death from heart failure and cancer, and causes deficiency of coenzyme Q10, a substance needed for energy production? I know what I would choose.

Margaret Moss nailed it all!

Up to now, the discussion leads to two partially opposite conclusions:

1) dietary supplements - no, healthy lifestyle - yes

2) dietary supplements - yes on individual needs, healthy lifestyle - yes, drugs - no

Although large RCT did not find much benefit from dietary supplements in the population perspective, the methodologically correct subgroups analyses should be performed. I also agree that the good quality products and in well planned combinations should be tested.

Margaret Moss I appreciate your point of view, but could you please provide some convincing literature supporting your claims, e.g. oral magnesium supplementation to reduce clotting or asthma symptoms, statins to increase the risk of death from heart failure and cancer. Thank you.

What do you think about extensive advertising of dietary supplements? Does it lead to non-rational use and overuse of dietary supplements? Does advertising have enough power to shape our believes about dietary supplements?

природні (натуральні )харчові добавки є джерелом мікроелементів, вітамінів, харчових волокон тощо, а також поліпшують смак, запах і колір харчових продуктів. Їх треба поширювати для користі здоров'я людства та прибутку тих,хто їх виробляє

Thank you Dr. Raksha-Slusareva,

I attach the translation of your answer to English (powered by Google Translate):

"natural (natural) nutritional supplements are a source of trace elements, vitamins, food fibers, etc., as well as improve the taste, smell and color of food products. They need to be distributed for the benefit of human health and the income of those who produce them"

@O. Raksha-Slusareva

Do you think "more benefit to human health" or "more income to producers"?

For this subject, I would recommend any of Dr. Sherry A Rogers MD, books and newsletters available at: prestigepublishing.com, telephone: 1-800-846-6687. She says all disease happens when toxicities go up and nutrients go down. In all her books and newsletters, she gives specific nutrients and brands--along with where available--that could help. Dr. Rogers is NOT beholden to any nutricieutical company.

Also, please check out the following references comparing adverse reactions of prescription drugs versus vitamin/minerals/botanicals--no doubt the latter is far safer than prescription drugs. Thank you.

References:

*GAO Report, March 2013, Dietary Supplements.

*NEJM, Emergency Department Visits for Adverse Events Related to Dietary Supplements, Andrew I. Geller, M.D. et al., 2015;373:1531-40.

DOI: 10.1056/NEJMsa1504267

*FDA Adverse Event Reporting System (FAERS), November 2015

Good quality supplements prescribed carefully according to an individual's needs are very valuable. Unfortunately many people think they know all about nutrition, take supplements they do not need, miss out supplements that would help them, and take supplements with harmful excipients. They do not work out how much of a nutrient they are taking. For example, they may take too much vitamin A, from liver, a multivitamin, and antioxidant and from cod liver oil. They may take too much selenium from a multivitamin, an antioxidant, brazil nuts and selenium containing shampoo. They may take too much calcium from milk, cheese, yoghurt and a calcium supplement. They may take vitamin B6 without the B2 needed to activate it. They may take too much calcium compared with their magnesium. We need to educate health professionals and the public in the responsible use of supplements.

Personally, I firmly believe in that foods are the best remedy, and we don't need any other medicine or supplements for our health. Just as what was stated by Luigi Cornaro in his book: "... they told me that I must only use food, solid or liquid, such as is generally prescribed to sick persons; and both sparingly.":

http://alternativehealthcommunity.com/luigi-cornaro-art-of-living-long/ 

But I know that such a statement has strong prerequisites. One has to have the self-healing capacity, the sustained upregulated autophagy, triggered in his body. And the statement that "food is the best remedy" would be a dangerous poison if we ignore the prerequisites.

Because of the diversity of our body, and the strong adaptation capacity of it, it is really impossible to prove if supplements are good or bad to health. Some people can go well with poisonous conditions. I once read a report saying that an old lady consumed tobacco heavily everyday, and when all her family doctors (younger than her) who advised her to quit tobacco were dead, she was still living healthily with tobacco.

"Let food be your medicine and medicine be your food" Hippocrates. I agree food should be the FOUNDATION of health but our soils have been so depleted that many times nutritional/botanical supplements are needed. Not to mention that many prescription drugs deplete nutrients--statins & CoQ10 for instance.

A chart from the US Dept. of Agriculture regarding soil depletion shows that since 1910-2006 mineral depletion has decreased ~ 90%. Sorry couldn't paste it--please look up on a search engine.

Also, consider an excerpt from the 1936 Senate Document 264 pertaining to soil mineral depletion. Presented by Mr. Fletcher during the 74th Congress and ordered printed by the USG Printing Office 1936:

“Do you know that most of us today are suffering from certain dangerous diet deficiencies which cannot be remedied until depleted soils from which our food comes are brought into proper mineral balance? The alarming fact is that foods (fruits, vegetables, and grains) now being raised on millions of acres of land that no longer contain enough of certain minerals are starving us—no matter how much of them we eat. The truth is that our foods vary enormously in value, and some of them aren’t worth eating as food.”

Maybe because of my experience, I'm not so pessimistic about our foods and the soil where our foods comes from. I agree that our foods are lack of some essential nutrients, and craving such essential nutrients leads to the overeating of some people and contributed to overweight and obesity. The most important nutrient in my mind is enzymes. a lot of essential enzymes needed for the proper functioning of our body are not able to be produced by ourselves, and we need them from food. But enzymes are very sensitive to temperature. Any temperature above 50 degrees Celsius will destroy them. To overcome this problem, I have included fermented food as part of my diet. And with the help of fermented food, I can comfortably adopt the Luigi Cornaro diet, in which only very small amount (few hundred grams a day) of foods is sufficient to support the daily needs of my body.

Thank you for your valuable contribution.

I totally agree that the diet, physical activity and psychosocial well-being constitute the major factors affecting our health. The theory of poor mineral soil composition could persuade me towards dietary supplementation, but the report by Marles (2017) Article Mineral Nutrient Composition of Vegetables, Fruits and Grain...

- Mineral nutrient composition of vegetables, fruits and grains is not declining.

- Allegations of decline due to agricultural soil mineral depletion are unfounded.

- Some high-yield varieties show a dilution effect of lower mineral concentrations.

- Changes are within natural variation ranges and are not nutritionally significant.

- Eating the recommended daily servings provides adequate nutrition.

Is the above report biased? What is the source of divergent opinions in this matter?

Eating the recommended daily servings provides adequate nutrition? For whom? How many people consume according to the recommendations anyway? We have polymorphisms in our genes, leading to more or less efficient production of proteins, and so to biochemical individuality. So recommendations for everyone do not work. Drugs cause deficiencies, increasing the need for supplements.

You go to a doctor and say you have sore eyes. You are given a drug. You go back to your doctor and say you are fatigued. You are given an antidepressant. You could have come to me. I would say fatigue and sore eyes could be due to riboflavin deficiency. Take some riboflavin, and you feel better.

You go to a doctor and say you had a fracture. You are given Fosamax. You go back and say you are anxious. You are given an antidepressant. You go to the doctor and are told your blood pressure is too high, and to take one or more drugs for that. You then have a heart attack, because your blood clots too easily. You could have come to me. I would say osteoporosis, anxiety and hypertension can all be signs of magnesium deficiency. You take a well absorbed form of magnesium, and you feel better. Moreover, magnesium inhibits clotting, and you might avoid that heart attack.

Ideally I take time, and assess various pointers to deficiencies, and if the money is available we carry out tests. Then supplementation can be used to address the individual's needs. Of course we address exercise and diet as well. It takes time, but it is time well spent, and saves time in the long run,

If only doctors were trained to spot signs of deficiency (and even excess), we could use supplements to prevent disease, reduce drug bills, reduce the side effects of drugs, and reduce the progression to more and more drugs, to deal with the side effects of the earlier ones. We have ended up with unaffordable health services. No one in the world can work out the interactions of the combinations of drugs that are prescribed. The statin inhibits production of coenzyme Q10, and so weakens your muscles so that you fall. The proton pump inhibitor reduces your absorption of minerals, and so your fall leads to a fracture. The fracture stops you exercising, and you have a stroke. You need acute hospital care, and long rehabilitation.

I suggest that medical training should start in the community, learning how to prevent disease. Acute hospitals may have glamour, but their size is a sign of failure to maintain health.

Good quality supplements used intelligently can prevent and treat health problems, in rich and poor countries.

Bravo to Dr. M. Moss!! Would like to add some statistics from:

NCHS Data Brief ■ No. 328 ■ November 2018, “Mortality in the United States, 2017”. SOURCE: NCHS, National Vital Statistics System, Mortality.

*Data from the National Vital Statistics System Life expectancy for the U.S. population declined to 78.6 years in 2017.

*The age-adjusted death rate increased by 0.4% from 728.8 deaths per 100,000 standard population in 2016 to 731.9 in 2017.

*Age-specific death rates increased from 2016 to 2017 for age groups 25–34, 35–44, and 85 and over, and decreased for the age group 45–54.

*The 10 leading causes of death in 2017 remained the same as in 2016.

Clearly the approach to health is all wrong as our life expectancy has declined. I think Dr. Sherry A. Rogers MD has it right when she says: “Chronic disease is caused by either environmental toxins or nutrient deficiencies”