The Dr. Hyman Show - Exclusive Dr. Hyman+ Functional Medicine Deep Dive: Nutritional Supplements

Episode Date: July 6, 2021

My team and I are excited to introduce our revolutionary new platform, Dr. Hyman+, which offers premium content, perks, and information available exclusively for Dr. Hyman+ members.  In this teaser episode, you’ll hear a preview of our latest Dr. Hyman+ Functional Medicine Deep Dive on nutritional supplements with nutritionist, Maggie Ward. To gain access to the full episode, head over to https://drhyman.com/plus/. With your yearly membership to Dr. Hyman+, you’ll gain access to: Ad-Free Doctor’s Farmacy Podcast episodes Access to all my docu-series, including Broken Brain 1, Broken Brain 2, Longevity Roadmap + bonus material Exclusive monthly Functional Medicine Deep Dives Monthly Ask Mark Anything by you and only for you

Hey everyone, it's Dr. Mark Hyman here. Now my team and I have been working hard on something that I'm so excited to share a little bit about today. It's a revolutionary new platform called Dr. Hyman Plus, which is a premium membership exclusive for my community. With Dr. Hyman Plus, you get a ton of private content and special access that no one else gets. This yearly membership gives you exclusive access to ad-free Doctors Pharmacy podcast episodes, access to all of my docuseries, including the Longevity Roadmap and Broken Brain 1 and 2, plus all the bonus content. You get monthly functional medicine deep dives where one of our doctors goes deep into a health topic to tell you everything you need to know to heal.

You'll also get access to a monthly Ask Mark Anything Q&A where I answer the Dr. Hyman Plus community's biggest health and wellness questions. This Q&A is only accessible with a membership. Now, because I'm so excited to share this premium membership content with you, I'm releasing a teaser of the brand new Functional Medicine Deep Dive episode diving into one of the most important topics in health. I hope you enjoy it and head over to drhyman.com forward slash plush. That's drhyman.com slash PLUS for more information. Okay, here we go. Hi everyone and welcome to another episode of Functional Medicine Deep Dive. I'm Maggie Ward, and today we're going to be talking about nutritional supplements.

I titled this the why, what, when, and how of nutritional supplements, sorting through the confusion. And I know this is a big topic with a relatively small amount of time to go through this, but I feel I'm trying to pick the main areas that you want to think about with nutritional supplements and hopefully give you some useful tips that you can take with you today to start making better, more informed decisions about your supplement use. So let's get started. Again, my name is Maggie Ward. I'm a nutritionist and registered dietitian. I'm the nutrition director at the Ultra Wellness Center in Lenox, Massachusetts.

If you're not familiar with us, I did put our website up there and you can follow me on Facebook if you want. I'm at Maggie Ward RD. I went to Bastyr University for my master's degree in nutrition and then went on to become a registered dietitian by completing my internship at Westchester Medical Center in New York. So why take supplements? I think a lot of you probably, you know, have answers to that. And I'm very much a food first person and nutritionist, but there are many, many cases where nutritional supplemental support can be very helpful.

And one of them, you know, top of the list there is decreasing quality of food. Our soils are quite depleted, you know, just in the last hundred years of how we do agriculture and the chemicals and whatnot that we spray on our food has done a lot to deplete the soil, how we grow our crops and only a few crops in a lot of areas has depleted our soils. There's a lot of talk about the benefits over organic versus conventional. And one of them is when you're eating organically raised produce, they have a lot more nutrients and vital chemicals in them because when plants are conventionally raised and sprayed with chemicals, they don't have to deal with the same pests and

threats to themselves. And therefore, they don't make the same amount of these chemicals that are protected for them as well as for us. And there's really good research now documenting the difference in nutrients compared to organic versus conventional. So that's number one on my list. Number two, I said it can be difficult to get everything that you need via food. I tend to, I feel I eat very well and think about my vegetables and plants. But sometimes I do fall short, I think of what I need and supplements can be aeted or low in certain nutrients. I put vegan there, for example, you know, someone who is strict vegan and doesn't eat any animal products. There are certain nutrients like B12. Sometimes the oils, the fats from fish can become depleted when you're not eating any seafood.

So that's where a really good instance where people usually benefit from some supplemental support. And then we all go through different cycles in our life that will often dictate what we need. We're going to get into that a little bit more, but nutritional needs do change over time from when we're a young person up into adulthood and then when we get older. And then a lot of what we see here is there's a lot of health conditions and diseases that are going to increase needs for certain nutrients. And this is where at least in the short term supplemental support

can be very helpful. We get into a little bit around genetics. The area of nutritional genomics is growing quickly and we're learning a lot about certain genetic variations that can increase need for certain nutrients, but also make it more difficult for some of us to get and use what we get from our food. And there are definitely areas where supplements have been shown to be really helpful for some of these genetic variations. Don't forget about chronic stress, especially after the year that we've all been through. When the body's under a lot of stress, we're using up more nutrients. Some of the B vitamins are a good example of that.

So in the short term, when you're under a lot of stress, supplemental support can be helpful. And then I also wanted to kind of threw in there the leaky gut, as many of you probably are familiar with that term. You know, one of the health conditions that we see so often here that's related to many other conditions is a compromised gut lining, where one, it becomes more difficult to absorb the nutrients you're getting from your food. So even if you are eating a really good balanced diet, supplements can be helpful to get in what you need, because you're having

malabsorption issues. And some supplements really can help in the healing process of the gut. And we're going to touch a little bit more on that further down. And the last thing I put some medications can deplete or interact with absorption for nutrients. A quick example, there are statins, which you know, many people take to lower their cholesterol, the same mechanism by which those work can actually deplete us of our coenzyme Q10, which I'll talk a little bit more in a moment. So regarding the medications, cardiovascular disease prescriptions and possible nutrient deficiencies. Now I listed quite a few different areas there in these different medications, and

we're not going to go into detail, but I just wanted to give you an example how these different categories and medications just within the cardiovascular area have been shown or been associated with deficiencies in these nutrients. So beta blockers, a lot of people take for blood pressure and things like that can defeat CoQ10 and melatonin, different types of diuretics because they're helping people bring their fluid down and to help with things like edema. Um, you often will lose minerals that work as electrolytes. So calcium, potassium, magnesium, um, some of the B vitamins and other minerals can be compromised. Um, ACE inhibitors have been shown to lower sodium and zinc, and then the HMG-CoA reductase inhibitors, again, which are the statin medications.

Um, again, they're going to lower CoQ10 often for individuals, but there's quite a few other nutrients that have been associated with low levels. That's carnitine, copper, the EFAs are essential fatty acids, as well as the fat soluble vitamins. Um, I listed their DNK, I'm sorry, D and E have been associated with these statins. Anything that's kind of blocking the production of cholesterol, which is a lipid of fat, it can impact the absorption of fat soluble vitamins like D and E. And the last one there, metformin is a medication for blood sugar issues, diabetes. It ties into the cardiovascular world.

So I put it here with these other ones. And again, CoQ10 comes up as a possible deficiency, as well as folate and B12. So something to think about if you or someone you know are on these medications, obviously, you know, speak to the provider who is prescribing them and maybe have this conversation and look into it further. But these are some areas that you would want to think about. So the second area I want to talk about are the acid suppressing medications, which unfortunately a lot of people are on and then they do often need them, but they can really deplete us

of a lot of nutrients. For some reason, we've forgotten that stomach acid is really critical for proper digestion absorption of nutrients. So short-term use really sometimes is needed, but I think it becomes more of an issue when it's long-term use. And unfortunately, these medications are being used for quite long periods of time, and they were really meant to be used. So I listed a few categories there, the H2 antagonists. I wrote some names there, Pepsid, Zantac, you might recognize the proton pump inhibitors like Prilosec, and then antacids, which, you know, a lot that's easy to get over the counter like Tums and Rolades. So all of these because they deplete your stomach acid, stomach acid is needed to

break down protein and absorb it properly. Minerals like calcium really need an acidic environment for proper absorption. And again, a lot of the B vitamins like folate and B12 are two of the ones that, you know, acidity as well as other variables, so to say, in the digestive tract are needed for proper absorption. So again, there's a place for these medications, but you definitely want to think about supporting people with sometimes supplemental support to override some of the deficiencies and then try not to be on them very long term. And I put a picture of their Prilosec OTC, which is over the counter. You can now buy Prilosec over the counter, which makes me a little nervous. You know, without doctor

oversight, I'm worried that some people, you know, will take this indefinitely, which definitely can cause issues. And then we have other prescription categories. So antidepressants I put up there, SSRIs are a big category where, which are the selective serotonin reuptake inhibitors. There is some research showing an association with lower calcium and vitamin D levels, as well as folate being low. And where you don't always know the mechanism of why these might be low,

but there's, when you do studies with them, a lot of it has been associated with lower levels. Oral contraceptives, you often see low levels of B6, B12 and folate as well as calcium and vitamin C. And then the NSAIDs, which, you know, a lot of us have to be on here and there for pain in general. You want to be careful with especially long-term use. So like long-term use of aspirin, because it can actually cause irritation in the gut and possible bleeding. Iron can become deficient for that reason and

also vitamin C. So anything that can be an irritant to the gut would often impact absorption, especially with long-term use. So let's move on to how to choose a supplement, which I think is where a lot of people might have some questions. And I'm going to give you some useful tips that I've used that I've used that I find really helpful, especially when I come in contact with a new product or new company that I'm not aware of. So the quality of the nutrients that they're using is really important. So there are more active forms of nutrients, and then there's more synthetic forms. And one of the best examples of that is folate. So there's

methylated folate, which is the fully active form that our body uses. And then there's synthetic folate. And then also methylcobalamin. Cobalamin is the biochemical term for B12. So the fully activated form is methylcobalamin. And then there's quite a few forms of it, but cyanocobalamin is more synthetic. So I put up a label here. So first of all, a supplement company should be telling you what form of the nutrient they're using. If you don't see that, that's not a good sign, and I would move on. But then most companies will tell you the form. So look down at the B vitamins.

So there they say folate, And you'll see right there, it says folic acid, folic acid is synthetic, and not always going to be an issue. But there, here's where some genetics come into play. There are people that have difficulty converting that synthetic form over into this more methylated form. What we get in our food is definitely more active. And that's not a concern. But it's the synthetic version that they fortify foods with and also add to supplements. And then right there is the B12, you see the cyanocobalamin, also synthetic.

So those are two things and you'll see that in obviously B complex, many times people will take these Bs on their own, multivitamins would have them. So it kind of covers a few areas of different types of supplement products you might be looking for. So that you'll see on a lot of labels.

So versus what you want to see is some word of methyl in there. This is a very, this is a specific type of methylated folate. The thing that you really just want to see is the word methyl in there. So if methyl is in there in some way with the word folate, you know, it's, it's a more active form and the same there, same thing there with the cobalamin, it's methyl cobalamin. So the other thing I look for is what are the other ingredients, right? Like, even like a food label at the bottom, they're going to say, what are the other ingredients that are in there? And just like a food label, less is better, right? Once you start saying a whole paragraph or two of ingredients, usually just just move on. I've

highlighted a few here. This is a very popular multivitamin that's on the market. And some of you, I'm sure I've seen it or taken it. And part of the reason it is a long list of ingredients is they are clarifying here what forms of nutrients are using like calcium carbonate. By the way, calcium carbonate is not a very well absorbed form. The citrate form of calcium is more what you want to look for if you is a preservative. It is allowed in products here in the US. In most of Europe, it's outlawed because it has been connected as a carcinogen. So I don't like to see any type of preservative in there that's artificial. Blue Two Lake, obviously, is an artificial coloring. You see those in foods you want to avoid them. You also want to avoid them in supplements. Corn starch, and there's modified corn starch in there. Not that corn on its own is bad, but I always want to make sure of the source of corn. Is it organic? Is it non-GMO? Corn is also a very common food sensitivity. So there are a lot of folks who are sensitive to it.

So you want to avoid those things that some people might be reacting to. Polyethylene glycol is in there, which, you know, can have some issues for people who are sensitive. Red 40 Lake, again, another coloring, you don't want that talc, which is powder. Now there's concerns of using talc topically, I don't know if it's been researched as much with ingesting it, but it's not something I want in supplements. Titanium dioxide helps to change the color, not really a good quality ingredient. And then again, another color in there is yellow six lake. At the very end too, it's telling you that it does contain soy. That's coming from the lecithin that's in there, which is a fat molecule. Again, not that soy is bad, but the quality of it, I would want to know,

you know, again, organic non GMO and soy is a very common food sensitivity. So for people who are sensitive, you know, you want to know that and honestly avoid it. So yeah, if you see all of this, you know, that's definitely a sign. It's not a very good quality product. So compared to this, this is a multivitamin from Pure Encapsulations, which is one of the companies that we like and use here at the center. The other ingredients is a vegetarian capsule of cellulose and water. Cellulose is just a plant fiber. And then a squirrebel palmitate is just a fat soluble form of vitamin C. So it is a preservative, but a natural form. It's vitamin C. And that's the

only two ingredients. So that's obviously reassuring. Part of it is this is a capsule. The other one was a tablet. So when supplement companies make tablets, often they are adding more binders and things to hold it together. There are some tablets that are well made, but in general, I do look for capsules. They tend to sit better with people and digest better. You can't always fit as much in a capsule. I think that's a big reason companies do use tablets. But again, you run the risk of getting a lot of other ingredients that you don't really want when you're having a tablet. The other thing you want to look for is the company should be saying, you know, it doesn't contain artificial colorings or flavorings or any of these common allergens.

Again, pure encapsulations have a certified gluten-free label right on there that the product's been checked for gluten. As many of you know, a lot of people are sensitive to gluten. If you have something like celiac, you really can't be ingesting any of it. So you want to know you're getting a product that's been checked and certified to be gluten free. So those are some of the symbols that you want to see on a product or on their website. Well, I hope you enjoyed that teaser of exclusive content that you get every single month with Dr. Hyman Plus. If you want to listen to the full episode and get access to ad free podcast episodes, plus all the content from my docuseries, and of course, any future ones we're going to release. Plus monthly Ask Mark Anything episodes, plus monthly functional medicine deep dive episodes.

I guess, right, that's why we call it Dr. Hyman Plus. Head over to drhyman.com forward slash plus. That's drhyman.com slash PLUS to learn more. I'll see you there. Hi, everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit

ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.