In my Confused About Supplements Newsletter I walked you through the beginning of my supplement journey. How I wrapped my head around the fact that in today’s world I needed supplements and once that was established how I learned to shop for quality supplements. I realize that we all are unique and have individual needs but in this newsletter I will again use myself as an example to illustrate the next step – how to put together a supplement regimen. I developed my supplement regimen OVER TIME and truthfully it is frequently changing but I will walk you through my process to give you some framework for building your own supplement regimen. SINCE YOU ARE NOT ME THIS IS JUST AN EXAMPLE- ALWAYS WORK WITH A SUPPLEMENT SAVVY PROVIDER TO DETERMINE YOUR NEED FOR SUPPLEMENTS. I think we can all agree that there are MANY supplements to choose from and the aggressive marketing of supplements can leave our heads spinning. That is where I found myself years ago. As someone who hadn’t been taking any supplements it was actually unnerving to see supplement bottles appear on my counter. So I made a commitment to myself – I would always research and know why I was taking a supplement. That habit has served me well compared to the willy nilly adoption of supplements that can occur in the age of clever marketing. My approach was first to start with what I called deficiency supplements then I progressed to treatment supplements and finally I added prevention supplements. So let’s take a look at what I added and why.
STEP ONE – DEFICIENCY SUPPLEMENTS:
My deficiency supplements are a multivitamin, omega 3 fish oil, vitamin D, vitamin B12, magnesium and iodine. To me if I had a nutrient deficiency that was an easy and common sense place to start. In general this includes important nutrients that I could test on lab work and if I tested low or sub-optimal for that nutrient and could not easily obtain it from my diet/lifestyle to me it was a no-brainer to add that nutrient to my supplement regimen.
MULTIVITAMIN/MINERAL SUPPLEMENT (MV)
There are essential vitamins and minerals that can be difficult to get from our diet for a variety of reasons. Food is not as nutrient dense as it used to be due to modern farming practices and the shipping that occurs from great distances. In the modern world we tend to not even rotate our foods with the seasons. Stress and toxins deplete our nutrients and finally if we are watching our weight it is difficult to get all the nutrients we need without overconsuming calories. I always try to eat a whole food diet and get the majority of my nutrients fresh from nature. Since this is easier said than done I add a MV from Wholescripts – Xymogens ActivNutrients one capsule a few times a week as an “insurance policy”. Using a reputable company can help assure the nutrients are in their optimal form which increases absorption and effectiveness. An example is that ActivNutrients has my B12 and folate in the methylated form. Why do I just take multivitamins occasionally? Well it’s complicated chemistry but in short I don’t want a nutrient from a bottle (which is in the correct chemical form but just is not as “alive”) to compete at that nutrients receptor and displace (only one at a time can fit on the receptor) the “alive” nutrient I am getting from my diet. “Alive” just means more electrical energy that actually helps the nutrient do its job. If my diet was poor and low in nutrients I would need to take the MV more often, maybe even daily, as the less “alive” bottled nutrient is better than no nutrients at all.
VITAMIN D3
To make your own vitamin D your skin needs to receive UVB light. You can also obtain vitamin D from a relatively few foods such as oily fish and liver. I am not afraid of the sun as it has many health benefits but being a Midwesterner the sun is often weak where I live and I avoid overexposure to the sun due to the UV aging effects on skin. I try to get some vitamin D from fish but as a Midwesterner I grew up with my mom rarely serving fish. As a result I am not that fond of fish and I am also aware that in our polluted world fish consumption has to be limited. Even though I was taking a MV with vitamin D3 the dosage in most MVs is quite conservative. As a result I could predict that my vitamin D level was low but to be objective I tested my 25 hydroxy vitamin D3 level. The optimal level in my opinion is 60-80 ng/ml (this important hormone has functions throughout the body) and my vitamin D was in fact not optimal. So I started Wholescripts – Xymogen Liquid D3 – for me it takes 4 drops every am to keep my level optimal. Xymogen’s Liquid D3 is cholecalciferol which is the correct form of vitamin D. I prefer the liquid since you can put the drops on your tongue or under your tongue avoiding the need for absorption in the GI tract (some of us have poor vitamin D (VDR) receptor function in the GI tract). For most people however the vitamin D capsules such as Xymogen D3 2000 or D3 5000 (depending on your need) are absorbed well in the GI tract and can easily elevate your level. Bottom line – If you know your genetics and have low VDR receptor function or you struggle to elevate your vitamin D despite supplementing with capsules then I would use the liquid. CAUTION – It is possible to get too much vitamin D since it is stored in fatty tissues so I always recommend monitoring your vitamin D level when you are taking a supplement. HELPFUL FACT – since many insurance companies including Medicare will oftentimes not pay for a vitamin D3 level – you can order your own. Well known labs such as Quest and Labcorp have self pay testing available directly to the consumer as well as many other online companies. No doctors order is needed.
OMEGA 3 FATTY ACIDS
Being a Midwesterner who doesn’t eat much fish it was obvious to me that I was low in the important Omega 3’s. Since I like to be objective I self ordered a test kit from OmegaQuant to test my red blood cell Omega 3 level and it was in fact low. This test with a simple finger prick looks at the percentage of Omega 3’s in your red blood cell membranes (Omega 3’s have MANY important functions but one is to improve the functioning of cell membranes). So since I was deficient I started Wholescripts -Xymogens OmegaMono Pure 650 one capsule a few times a week. How much you need depends on your Omega 3 percentage. Omega MonoPure is an IFOS (International Fish Oil Standard) certified oil that is tested to assure it is not contaminated and that it is fresh (not rancid) oil. Oils are very susceptible to degradation when exposed to oxygen, light and heat so I only use companies that test for the lipid peroxides that can build up in an oil and cause it to become rancid. I also only order oils from reputable suppliers such as Wholescripts that keep the oils in temperature and humidity controlled environments and ship them directly to me avoiding 3rd party additional warehouse. This type of quality is of utmost importance since poor quality oils can negate the many health benefits of fish oils. Many, many studies tout the benefits of adequate Omega 3’s for health but the few studies that don’t I believe used inferior oils or the wrong dosage. HELPFUL FACTS – If you have bleeding tendencies, are on blood thinners or have atrial fibrillation always consult with your provider before using fish oils. When you buy oils do not buy more than a 3 month supply and keep it in a dark, cool environment as even a quality oil becomes rancid with time.
VITAMIN B 12
I test my vitamin B12 level since this important vitamin is needed for proper metabolism, hormonal function and brain health to name just a few of its important functions. B12 can be obtained fairly easily from the diet (unless you are a vegan/vegetarian) and I was getting some B12 in my MV. In my case though I knew I needed high normal levels of vitamin B12 since I have one variant of the MTHFR gene and my homocysteine level can be high normal – both of which can indicate a greater need for vitamin B12. For optimal B12 I started Wholescripts -Xymogen’s Methylcobalamin one tablet dissolved under my tongue once a week. Dissolving it under my tongue increases absorption. Folate and other B vitamins are also very important but my lab tests for these nutrients were normal. HELPFUL FACT – If your doctor won’t order tests such as a B12 and homocysteine again these tests can be self ordered through online sources. Genetic testing is also available through online companies such as 23&me.
MAGNESIUM
Magnesium is a very important mineral involved in functions throughout the entire body. Since I knew that in today’s world our soil is depleted of magnesium and in today’s stressful world we need more of the calming effects of magnesium I checked my Red Blood Cell (RBC) magnesium level (this is more accurate than checking a serum magnesium level). My level was not optimal and I was having excitatory symptoms such as leg cramps, difficulty sleeping and some anxiety so I added Wholescripts – Xymogen OptiMag Neuro one to two capsules daily to my supplement regimen. This is a blend of several forms of magnesium since different types of magnesium enter different tissues. I wanted the benefits of the calming magnesium in tissues such as my muscles but I also wanted it to cross the blood brain barrier so that I received the calming effects in my brain. OptiMag Neuro has magnesium in the threonate form which will cross the blood brain barrier.
IODINE
I don’t use conventional iodized salt and I don’t eat much seafood. I also have a history of being hypothyroid so I know iodine is important for me. Sure enough my lab test did reveal I had a low iodine level. Iodine is actually needed to make important T3 and T4 thyroid hormones (T3 means 3 iodine molecules and T4 means 4 iodine molecules). Since I didn’t want to add iodized salt or eat more seafood I started Wholescripts – Xymogen MedCaps T3 one capsule every am to supplement iodine and other important thyroid nutrients.
CALCIUM
So you may be surprised to see that calcium is not one of my deficiency supplements so let me comment on that. Years ago (with a lot of input from the dairy industry) women were urged to get 1200-1500 mg of calcium daily. Back then no one even checked a woman’s vitamin D level. Fast forward and we now know that for bone health it is very important to have an optimal vitamin D level. When vitamin D is optimal calcium is absorbed and used much more readily in the body. We also know that too much calcium can end up causing deposits of calcium in places we don’t want it – like in our blood vessels and tissues. Finally blood work is not a reliable indication of your need for additional calcium – your calcium level which is obtained as part of a metabolic profile will usually be normal as the body tightly regulates calcium and if it is low it pulls calcium out of the bone to increase your blood level of calcium. If you take too much calcium you excrete the excess. So the best way to assess your need for calcium is to calculate your daily intake (many food charts are available online to help you do that or you can use an app like chronometer). My current recommendation for women is to optimize their vitamin D and then I recommend a goal of 600-800 mg of calcium daily (diet + supplement). I do get calcium in my diet and in my MV so at this time I do not need an additional calcium supplement.
STEP TWO: TREATMENT SUPPLEMENTS
My treatment supplements are around bone health and hormonal balance. In general (obviously there is some overlap between deficiency supplements and treatment supplements) this category for me includes nutrients that I can’t test for on bloodwork but that are known to help reduce a disease process in the body that I am concerned about.
BONE SUPPORTING SUPPLEMENTS
I am a small white woman at risk for osteoporosis and I have in fact been diagnosed with low bone density. Many nutrients are involved in bone health. As I stated above I am careful to keep my vitamin D optimal and to calculate my calcium intake and keep it optimal. I will also mention that vitamin K is important for bone health and my vitamin K level is optimal (probably due to the fact that I tested it after I had added the Vital Proteins product discussed below which contains vitamin K and I do eat foods that have vitamin K). What many don’t realize is that the bone is 50% collagen – which is what keeps the bone flexible and less likely to break. I don’t have a good way to test my collagen status on lab work but a low bone density certainly points towards my need to maintain adequate collagen. As we age we produce less collagen and begin to see the changes in our bone, skin and hair since these are all collagen rich tissues. I added Wholescripts – Xymogen’s RegeneMax Liquid 6 drops daily to my regimen as it contains choline stabilized orthosilicic acid which stimulates the body to continue to build collagen as we age. CAUTION – This tastes horrible so I add it to a small amount of unsweetened juice. Then more recently I wanted the one – two punch so I added an actual collagen supplement to my regimen so that when my body did want to make collagen I was making sure it had adequate building blocks to do this. I added Wholescripts – Vital Proteins Professional BioActive Collagen Bone and Joint Support one scoop daily.
HORMONE METABOLIZING/DETOXIFYING SUPPLEMENTS
I went through menopause in my mid 40’s and have been on Bhrt ever since. I obviously know there are many benefits to Bhrt but hormones can also be toxic if they build up and the hormone levels become too high. Once a hormone docks on its receptor in tissues and causes an action (such as supporting the growth of bone) the hormone then leaves the receptor and needs to be eliminated so that excess levels do not build up. The liver is key to proper hormone elimination but our poor liver is also busy detoxifying many other substances we are exposed to on a daily basis. BOTTOM LINE -as we age our liver can use some support. Since I am on hormones and I am aging with an older liver I like to support my liver with a variety of supplements. I tend to ROTATE several liver support supplements Wholescripts – Xymogen’s XenoProtX one daily or Xymogen’s Liver Protect one daily or QuickSilver Scientific Liver Sauce I tsp daily. Any of these are great options so it doesn’t need to be this complicated – I am just sharing what I do to “treat” my liver.
STEP THREE – PREVENTION SUPPLEMENTS
Again I don’t mean to be confusing – the 3 categories of supplements I am outlining do overlap but basically for me this category is anti-aging supplements. It is not that I know I am low in these nutrients (no great lab tests for them) and it’s not that I have been diagnosed with something that I need to treat. It is just me combing through the research and finding nutrients that are very promising for maintaining the function of the body as we age. We will all age but we want to have quality of life for as long as we can prior to death. Most of the antiaging research focuses on keeping inflammation low (a healthy immune system), mitochondria health, DNA and telomere stability, proper nutrient sensing and proper cellular and intercellular communication. Aging is a complicated process and we are in the infancy of understanding it. You could overload on supplements if you took everything that is being touted for antiaging. Since I don’t like to overload my supplement regimen I rotate several antiaging supplements that I feel have good research behind them.
CURCUMIN
Since curcumin helps the body eliminate old senescent cells that accumulate as we age and interfere with optimal functioning I take Wholescripts – Xymogen CurcuPlex 95 one daily in rotation with my other antiaging supplements. This is a very bioavailable form of curcumin.
RESVERATROL
This polyphenol supplement has many benefits such as reducing inflammation, improving mitochondrial function and removing old cells. I take Wholescripts – Xymogen Resveratin Plus one daily in rotation with my other antiaging supplements.
QUERCETIN
This is another polyphenol with the benefits listed above for resveratrol. Conveniently the Resveratin Plus that I take for the resveratrol also contains quercetin.
CoQ10
This supplement supports mitochondrial function (those important little cellular organisms in every cell but your red blood cells) and reduces inflammation. I take Wholescripts – Xymogen CoQmax Ubiquinol one daily in rotation with my other antiaging supplements. This type of CoQ 10 is more absorbable.
That’s it! I know it seems like a lot of supplement bottles for someone who used to not take any supplements – but true to my mission I know the rationale for why I am taking any and all of my supplements. This is just an outline of how I built a supplement regimen but it is always evolving. Periodically I like to re-evaluate my health and make any needed changes. I am also constantly studying the literature and learning new things that result in changes to my supplement regimen. Finally I also take supplements as needed for temporary conditions such as when I am ill or exposed to illness but they are not part of my routine regimen.
HEALTH YOURSELF ACTION
Use this guideline to help you develop or refine your supplement regimen. If you feel overwhelmed – take it one step at a time like I did. If you need a source for quality supplements see my Confused About Supplements newsletter that teaches you how to shop for quality supplements. There are many quality supplements available but my go to source as I stated in my last newsletter is www.wholescripts.com
I do not think the current healthcare system is giving women the respect and attention they need and sadly I don’t see this changing anytime soon. PROACTIVE women are not sitting around and waiting for that change – they are learning what they can do themselves to optimize their health now. I am on a mission to educate and assist women in attaining the health they deserve.
Your Womens Health Expert and Advocate
Brenda S. Smith, MD
