Supplements – Do I need them?

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by Dr Sandra Cabot,MBBS, DRCOG

This is a very interesting and often poorly answered question. In Australia the regulations mandate the statement “Vitamins and minerals can only be of assistance if the dietary intake is inadequate.”

In the USA the statement that is mandated by the FDA is “This supplement is not intended to diagnose, treat or cure any diseases.” This is less confusing than the Australian statement but can have negative implications for those with conditions that can be improved (not necessarily cured) by dietary supplements. For example, urinary tract infections can be reduced by daily vitamin C supplements and many types of goitres can be reduced by iodine and selenium supplements in deficient people. Migraine headaches and painful cramps can be reduced with magnesium supplements. Recurrent and chronic bacterial infections associated with biofilm, can be reduced by supplements of N-Acetyl-Cysteine (NAC).

The general public easily become confused by these government statements and negative coverage of supplements in the press. Sure, there are plenty of scams and ridiculous advertising out there, especially on the Internet, so do your own research and look for the evidence or see an integrative medical doctor or highly recommended nutritionist or naturopath to be guided professionally.

Saying that supplements can only be of use if the dietary intake is inadequate is a very general statement and does not take into account the many variables that affect human health.

Now what is a perfect or an adequate diet?

Well that varies greatly because people have different genetic variations (polymorphisms) which make their metabolism unique and sometimes imperfect. For example, if they carry a defective gene for the biochemical process of methylation, which is fundamental to metabolism, they will need extra and activated B vitamins. A regular adequate diet will not be enough for their optimal health.

Another example is an older person who does not make enough stomach acid will have difficulty absorbing minerals from the adequate diet that they try to eat. For sure they will need to take minerals such as calcium, iron and magnesium. This also applies to people taking drugs to block the production of acid from their stomach. It is also well recognised that people taking stomach acid blocking drugs long term, cannot absorb vitamin B 12 properly from their gut; in such cases vitamin B 12 injections are needed.

Some people have a genetic variation of the vitamin D receptors on their cells which necessitates higher requirements of vitamin D. In such cases they would need to spend a lot more time in direct sunlight or take vitamin D supplements, as they can never get enough vitamin D from their “adequate diet”. They would have to have an Eskimo diet of whale blubber!

The problem known as “leaky gut” is common and means that the lining of the gut is inflamed and excessively permeable to toxins and unwanted chemicals. Gut inflammation can be caused by the wring types of bacteria in the gut, some medications and food allergies. In people with a leaky inflamed gut the absorption of nutrients is compromised, and deficiencies of vitamins and minerals are a big risk. It is vital to repair the gut inflammation and supplement with essential vitamins and minerals until the gut is working properly.

Infections of the gut with unhealthy bacteria such as Helicobacter Pylori, Small Intestinal Bacterial Overgrowth (SIBO), and the yeast Candida can reduce the availability and absorption of nutrients from the diet. These parasites steal our nutrients, make us crave sugar and can cause a leaky gut. It is not uncommon to see deficiencies of vitamins and minerals in such cases.

People with chronic viral infections require plenty of the mineral selenium and there are many good references on this. With a worldwide deficiency of selenium in the soils it is easy to get deficient in this immune-enhancing mineral if you do not supplement a so called “adequate diet”

Similarly, it is easy to become deficient in the mineral iodine, unless you eat seaweed regularly, as farmed fish don’t eat seaweed. Even if you eat seafood do you eat it 3 times a week or does your diet vary a lot. A significant number of people hate seafood and so they take fish oil supplements, but this does not provide iodine. Iodine is essential for the thyroid gland, healthy breast and prostate tissue, the developing foetal brain and immune function. You do not want to be deficient in such as important mineral.

If you have lost your gallbladder or have a dysfunctional gallbladder, you may not produce enough bile. You need to take capsules of ox bile or supplement with fat-soluble vitamins, A, D, E and K otherwise you will struggle to absorb them from an “adequate diet.”

If you have a fatty or dysfunctional pancreas you will not produce enough digestive enzymes to break down and absorb protein and fats and fat-soluble vitamins. You can take pancreatic digestive enzymes with meals and this will help a lot. You may also need to supplement with the amino acids tyrosine and glutamine to ensure adequate intake of protein.

In our clinic we see a lot of nutritional deficiencies in patients whose diets are reasonably good by conventional standards.

The most common deficiencies we see in pathology testing are

Low vitamin D
Low iodine
Low selenium
Low zinc
Low iron

So, as individuals we need to have a diet and possible supplement program that is tailor made for our genetic uniqueness and lifestyle.


Dr Sandra Cabot MBBS, DRCOG,  has several medical clinics in Sydney and is the author of 30 books on health. She is the Medical and Executive Director of the Australian Women’s Health Advisory Service. This service was established in 1982 and since that time has provided free help to people all over the world via phone and the Internet.

For more information go to  https://www.cabothealth.com.au/

Dr Sandra Cabot will be at the Conscious Living Expo and is giving a seminar Saturday October 26 and Sunday October 27. Stop and see Dr Sandra Cabot at  Booth 7 at the expo where she  will be available to answer your questions. To read more click here

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