My apologies but going to get on soapbox for a moment. As an ER doctor I tend to notice when people are doing foolish and or dangerous things. That applies to this forum. My being a physician does not make me smarter or more knowledgeable than anyone else here, but I have a lot of experience. Things I’d recommend to people here.
Do not assume a supplement is “safe”.
Supplements are not “natural” in the doses they come in. Consider them “drugs”.
Supplements interact with other supplements and medications.
Supplements can be toxic at higher doses.
Do not assume anyone on this forum knows what they are talking about. Some people are clearly on the wrong part of the Dunning Kruger curve.
A supplement may affect you differently than others based on other supplements and meds you take, health issues you have, your diet and your metabolism.
The benefit to risk ratio is not overwhelming. You probably will get a minor benefit from supplements, so when in doubt, stop taking them until you feel they are safe.
Exercise, a healthy diet, normal body weight, good sleep, and stress reduction are far superior to any supplements.
Use one of the major Ais (Claude, Gemini, or ChatGPT) to help you do the analysis. I recently did this with my supplement stack and we identified several severe risks that were previously unknown to me. This cause my to eliminate some supplements and adjust my dosage and protocol for others.
oh yea I’ve pitted the AIs against each other and have run many iterations of my protocol, yet still, some things it agrees with and then I have to find the problems with it… which suggests there are inherent problems with that approach.
But it is definitely helpful. I suppose after a while, we become the experts.
It would be helpful to give examples. Obviously, that wouldn’t be all inclusive but eventually crowd sourcing has a value.
I’ll give mine. A patient misheard or misread instructions and took 50,000 IUs if vitamin D daily. He showed up in an ER and got admitted for hypercalcemia. It was at least a few days in the hospital.
I don’t know what symptoms he had but hypercalcemia is moans, bones, stones and abdominal groans (by memory - don’t quote me). Kidney stones, abdominal pain (inc acid), bone pain and you can have mental status changes.
It can cause death from cardiac instability but that doesn’t count as a symptom.
I had a married couple both get ulcers from some tumeric. It was a very pure powder their naturopath gave them. One bled and one perforated in the first 2 months on it. They both had gastric bypasses which have a high risk of ulcers. I imagine the dose was very high but they never brought it to me.
Those are my 2 personal examples. An ER doc should definitely have more.
So far, the examples of problematic supplements (vitamin D and turmeric) are when an excess is taken. I switched from taking most of my supplements from every day to every other day and some even every 3rd or 4th day.
Very true. Toxicity is a problem. This can result from overdose (if some is good, more is better), confusing supplement doses with medication doses (Lithium), or toxicity because of other health issues such as kidney disease that causes your body to not normally clear the supplement.
Like almost everyone here, I read papers that are most relevant to my age and condition. Supplements, which I screen, have been as beneficial to me as my prescriptions. Yes, tumeric can be corrosive, but ginger safely addresses many symptoms. Lithium may be questionable, but lactoferrin clearly helps reduce inflammation. Moderate doses of zinc and magnesium citrate are successfully treating a case of acidosis, which has a high mortality rate, and which Nephrology couldn’t help me with.
My supplements are worth the cost. And cost is a factor. Insurance has gone up sharply this year, not to mention groceries. India is a great resource, but if I am further squeezed, I may move to Ecuador, where one can live royally, with private medical care, on $3k/month.
Metabolic acidosis is common in CKD, and it becomes more common as kidney function declines. Even in stage 3 CKD, 10–20% can have low bicarbonate, and the prevalence rises sharply in stage 4 and 5. I watch it closely and try hard with diet and some supplements to keep my bicarbonate at 23-24, and urine Ph at least at 6. I take Citra Tabs once a day and eat a lot of alkali- producing veggies to make sure that I don’t develop acidosis.
Matt Keberlein seems to be of similar thought. He suggests only taking supplements that address a known deficiency. His stack seems quite small compared to the 20+ ones in mine. I think a lot of us, including me, have heard about the benefits of a supplement and add it to our stack hoping for the best.
I’ve been watching Quinn Stillson’s channel on longevity. He discusses supplements related to longevity, including dosages and time to initiate their use. Maybe check it out.
Don’t take twice a day because only 1 holds my bicarbonate as well as potassium in a healthy level. If I take it twice potassium goes up to borderline high (I’m also on telmisartan). All in moderation is the answer.