A Supplement About Supplements

What should we take, if anything?

Is this what it’s come to?

The incentive for this post came from my friend Julia, who continues to inspire me with her posts and discoveries that she shares. If you are over 60, and have ever uttered the words “I’m too old…” you absolutely need to subscribe to her Substack. She is a remarkable woman who has seen and done more AFTER the age of 60 than most folks do in their entire lives, and she’s not letting up on the gas.

So let’s talk about supplements. They are the pills, potions, and elixirs that we take in addition to the food we eat. After doing a 5-part series (Part 1 here if you missed it), I realized that nearly everyone takes something in addition to their daily meals. In thinking about supplements, it occurs to me that there are a number of different types. They are different enough that I think it’s best to discuss each type separately.

Prescriptions

You may not consider prescriptions as supplements, but they are substances that are taken in addition to meals. In fact some must be taken before meals. Others may be need to be taken on an empty stomach. All prescriptions are (or should be) issued by a doctor. Most are given to manage a disease or condition, meaning they deal with symptoms. The word cure is rarely used any more. In most cases you are expected to take the prescription as ordered. Since regaining my best health in my 70s, I have a very high degree of skepticism about all prescriptions.

When a prescription is mandatory to keep the patient alive, clearly there is no choice. But it’s important to realize that every prescription comes with side effects. Before taking one, I research the side effects on the website of the company that made it. If I feel that the side effects may be worse than the condition being treated, I will not use the medication.

If you ask your doctor about side effects or safety of a drug, you’ll likely be met with a patronizing statement about it being very safe. Take fluoride, for example. It’s so safe that it’s in the water of most cities. But as Rand Paul has discovered, it is a neurotoxin that can cause brain damage. And, of course, there’s the torrent of awful outcomes, in the wake of the entire COVID-19 pandemic, that are finally coming to light.

Our Food and Drug Administration, the FDA, is supposed to have our back with regard to safety of both foods and drugs. However there are very close ties between the FDA, pharmaceutical companies, and food manufacturers. The attribute of generally recognized as safe (GRAS) is applied to all sorts of things, including the aforementioned fluoride in the water, and many food items that are banned in other countries.

My bottom line on prescriptions is that I want the reasons for them to be fully explained, and I want to understand all the potential side effects. Only then am I able to make the decision whether or not to take them.

Vitamins & Minerals

The fact that we are here is proof that our ancestors did just fine before vitamins were even discovered, let alone manufactured. Yet there are minimum daily amounts set for nearly all of them. Do we really need vitamins, and if so, why?

Go back a couple of hundred years, when a substantial portion of the citizens of the United States were farmers. The soil was rich, and plants came packed with most of the vitamins and minerals needed to promote good health. When jobs in the cities paid better than farming, without the risk of drought, insects, or worse, lots of people left the farm. Big corporations moved in, bought up the land, and began using techniques to force higher crop yields without regard to the nutritional content of the food they produced. As fields were used over and over to grow the same crops, it became necessary to use massive amounts of fertilizer to literally force plant growth. Each harvest took some nutrients out of the soil that never got put back through proper land management.

The first signs of this were observed in the cereal grains. Bread and breakfast cereals now all have vitamins added, proudly proclaimed on the packaging. Even that was not enough, and now every supermarket and warehouse store has massive numbers of vitamins available for purchase. Do we need to take them?

Well maybe. If you are deficient enough that symptoms appear, anemia for example, then obviously they are necessary. But when you consult the vitamin information of a food package you’ll find percentages of the recommended minimum daily amount (RMDA) for each serving. If you maintain a meticulous log of exactly what you eat each day, adjusting for the serving size based on the amount the food weighed before you ate it, you just might be able to see if you are getting enough. And that’s only for the standard vitamins. And assuming that the RMDA is right for everyone.

Nobody wants to do that. Luckily you can just take a daily vitamin, with all the stuff you need encased in one capsule, tablet, tablespoon, or (shudder) gummy bear. Problem solved, right?

Not so much. Not all of the vitamins you need are in the multi-vitamin. It’s also a “one size fits all” approach. As we get older, our needs change. It’s easy to become deficient without realizing it. We could ask our doctor, for example, “How much vitamin C do I need?” You might get an answer parroting the RMDA for C, or you might get a blank look. Doctors are not trained in nutrition. Those who write books about nutrition always seem to have a website that sells the vitamins they recommend in the book. Given that most books, written by authors less famous than Stephen King or J.K. Rowling, sell between 12 and 1,000 copies, I guess they need the money.

My wife and I take a multivitamin formulated for seniors on a daily basis. We watch the lab results from our twice-annual exams. As long as all the numbers look good, we leave it at that. In truth we are probably excreting a lot of the vitamins we ingest. My father did warn me not to pee my money away.

Herbal Supplements

The vitamin aisle of your local supermarket or pharmacy also has lots of supplements from herbal sources. Being a man over the age of 60 puts me in the 70% of men with benign prostate hyperplasia (BPH). This condition has been the norm for many generations, so there are quite a number of remedies available using plants and seeds. I take a daily capsule filled with a concoction made from various natural ingredients. It’s augmented with a capsule filled with the root of stinging nettles, which makes it work even better. Using the leaf of the stinging nettle is also quite good for resolving allergy symptoms without the usual side effect of drowsiness that comes with commercial preparations.

There are a number of problems with these natural supplements. The FDA doesn’t do much regulation, short of making sure they won’t kill you instantly. The product on the shelf may come from a sterile production facility, or from herbs that some guy collected from a field, crushed by driving his truck over them, and sweeping the dust into capsules. You can’t tell. As for testing, you are both the tester and the test subject. I’ve found some brands that I like, but when ordering online it’s basically pay your money and take your chance.

There are lots of multi-level marketing programs (aka pyramid schemes) that sell natural herbs with exotic pedigrees, with the promise of losing weight, keeping hair, growing various body parts, etc. Most, maybe all, of these are not selling products, but recruiting more salespeople to push money back up the line to the top of the pyramid.

In the past few years, television has been saturated with ads for vegetables and fruits freeze-dried and loaded into capsules. The promise is that you’ll get a balanced diet without needing to eat all those vegetables and fruits. Each ad features one or more people who were lacking energy, unable to enjoy life. Once they subscribe to the program and take their pills, life becomes good again and they can run a marathon every week. In reality I am skeptical of how much they can actually stuff into a capsule, and how much vitamin content is lost in the heating and dehydration. There’s also none of the fiber from the original fruits and vegetables. Most likely the only balance being achieved is the one that increases at the company’s bank.

There’s one other herbal supplement I haven’t addressed. Coming of age in the 60s, I should be somewhat knowledgeable about cannabis and related herbals. But not only did I not inhale, I didn’t light up or partake. This was not due to religious convictions, fear of authority, or anything like that. Being singularly non-athletic, last chosen for any team sport, I had come to realize my brain was my only asset. I simply did not want to risk any damage to it. Some would say I did not succeed.

There are a lot of people that have found marijuana and/or cannabinoid products to be helpful for a lot of health issues. I have no issue with that, and if the need ever arose, I would probably go the same route. But lacking personal experience, I can’t comment further.

Magic Supplements

Many years ago the CBS television show 60 Minutes did a segment on the good health of people in the Mediterranean. Research had come up with the idea that resveratrol, a compound found in grape skin, was the secret. The theory was that in countries where a lot of wine was consumed, this compound would be the secret. After the program aired, wine sales soared. Even grapes became more popular. Research then, and even now, has not supported the idea the red wine is the secret to a longer life. For those that consume it in quantity, wine may actually be a shortcut to the cemetery.

As related in this article, scientists are starting to look at existing drugs in the hope of extending lifespans. One of those is Rapamycin, derived from a fungus found on Rapa Nui, also called Easter Island. Currently it is used to suppress immune response to prevent rejection in organ transplants. In experiments with mice, using it as a supplement allows them to live 15% longer. It seems to work by causing cells to recycle damaged proteins. Already tested extensively, and proven to be safe for use in humans, we can probably expect drug companies to start producing this at scale any time now.

Another repurposed drug is metformin. It is normally prescribed to those with type 2 diabetes. It reduces insulin, which also reduces the protein that regulates protein production in cells. Metformin has been around long enough for the side effects to be well known, and some of them can be serious. Like many drugs, it can be prescribed “off label”, meaning used for a purpose other than originally intended. There are clinical trials underway to explore the use of this drug to extend longevity.

If either of these drugs prove to extend lifespan, they will be pushed to market. We’ve already seen this with another diabetes drug, ozempic. Once the weight loss effect of it became known, it quickly became popular with the glitterati. Doctors of the rich and famous began prescribing it, and users of it were eager to share it with friends. Of course it had not been extensively tested for use on people who were not type 2 diabetic. It has already become obvious that once you stop using the drug, all lost weight returns with a vengeance. There are also concerns about long term damage to the gastrointestinal tract.

In addition to the above medical and legal supplements, there is an endless supply of the type commonly known as snake oil. These are concoctions that make exorbitant promises, but at best do nothing. Sometimes they can cause serious harm. They are sold online with click-bait headlines like this:

Eat this before bedtime and lose weight. It has only two ingredients!

If even one of these promises were true, you can be sure it would be on the shelf in every store. These supplements are largely unregulated, and could be dangerous. If you are lucky, your money will be the only thing you lose.

Exercise

Yes, I’m well aware that exercise is not a supplement. But it is probably the single most effective thing you can do for your health, and it doesn’t have to cost you any money. You can achieve fitness with as little as a good pair of shoes. The benefits of exercise impact your blood flow, which in turn helps your brain. The physiology behind it is explained in this article. It recommends a minimum of 150 minutes of aerobic exercise per week.

My wife and I get almost 3 times that much in our daily 5k (3.1 mile) walk. After we’d been doing this for a while, I noticed a change. The fog clouding my thinking lifted. I began to remember things from my childhood that I’d thought were gone forever. Coding new features for my apps has become easier and more efficient. All my health markers are well above the average for people my age.

Perhaps you’ve been unable to exercise much, due to obesity, arthritis pain, or shortness of breath. Most of that can be treated with diet, and should not hold you back. When we first started walking, we could not go much further than a city block. The secret is repetition. If you can only walk to the mailbox today, do that every day until you can do half a block. As soon as it gets easier, do a little more.

It can be helpful to walk with a friend, even if that friend uses four legs instead of two. (I don’t know if you can walk a cat on a leash, but I suspect a dog is a much better choice.) Many years ago a neighbor who was recovering from surgery ask me to accompany him on a daily walk. Within a year I was running two miles each day, having two dogs on a leash attached to my belt. We looked very odd, but the dogs and I really loved it. When the dogs passed away I stopped, and only now do I realize what a mistake that was.

If you’ve made it this far, congratulations and thank you. I hope it helps you on your journey to optimum health!