Food First

I’m a food girl, first and foremost, however, there are important reasons for using supplements to augment the nutrition we receive from our food. In Functional Medicine, food and nutritional supplements are foundational tools for optimizing health and reversing troublesome health problems. Food is our foundation. Supplements are just that–they supplement what we eat.

Why do we need nutritional supplements?

  1. Modern soil and environmental conditions do not favor nutrient-rich soil for growing plants or raising animals that are optimally nutrient dense.
  2. Modern farming practices deplete the nutrient content of soil used to grow our food.
  3. Our bodies are highly stressed by our modern world and toxic environment–this depletes us of vital nutrients that may not be repleted by our diets, no matter how careful we are about what we eat.
  4. We are each genetically unique. Some of these uniquenesses endow us with special nutritional needs that cannot be addressed adequately by food alone. We’re so fortunate to have these wonderful tools to work with.
  5. We can use many nutrient and plant supplements to modulate and improve our body’s function even when we don’t have a deficiency.
  6. Many well-made food supplements help make our lives more convenient.
  7. Many of us are highly active, and have protein and micronutrient needs that surpass what we can get from food.

While in my medical practice I choose to perform comprehensive nutrient testing to determine with precision what my clients’ nutritional needs are, there are also some sensible supplements that most people benefit from without the scrutiny of testing.

Here are my top ten nutritional supplements:

  1. Vitamin D: Most of us who don’t supplement are deficient (as shown with blood testing). On rare occasions I will have a client who eats sardines every day and has a normal vitamin D level. Everyone else needs to supplement. Vitamin D is a multi-tasker, with vital functions relating to bone health, immune function and brain health. Take a minimum of 2000 IU daily. It is best to have a blood test for 25-hydroxy-vitamin D. This will determine how much you need long-term. I find that people in my medical practice (myself included) need 5000-10,000 IU per day to achieve the minimally acceptable blood level of 50 ng/ml. Take with a fatty meal for best absorption.
  2. Probiotics: These are the healthy bacteria that reside in our guts that have been shown to have a huge impact on our health, including orchestrating healthy immune function. These fortifying bugs are assaulted from many aspects of our toxic environments, food, and medications that we take (antibiotics, for instance). A great many of us were exposed to antibiotics as children, the critical period for establishing a healthy microbiome, so we need the support. Eating cultured foods is great, but I think it makes sense to include a daily probiotic as well. Take one that has a combination of species from the lactobacilli and bifidobacteria family, as well as probiotic yeast, saccharomyces boulardii: 30-60 billion organisms per day, taken with food.
  3. Fish Oil: The EPA and DHA in fish oil are omega-3-fatty acids, fats that are essential to good health. We can get these from fatty fish (wild-caught salmon and sardines), some nuts (walnuts) and seeds (flaxseeds, hemp seeds), however, there are toxicity concerns about eating fish frequently, plant sources are often not adequate, and there are often reasons why we would want to use large doses to modify inflammation. It is important that the source you use has been tested for potency, as well as mercury and pesticide contamination. For general health, take a combination of EPA and DHA that equals approximately 1000 mg per day. For modulating inflammatory conditions, take a combination of EPA and DHA that equals 3-5,000 mg per day. Take with food.
  4. Multivitamin-mineral: After year of testing nutrient levels in my clients it has become clear to me that most people benefit from a high quality multivitamin-mineral supplement. There is a wide range of what is available out there. Stick with a trusted company (for me this is Metagenics, Designs for Health, or Xymogen), follow the directions on the bottle, or fine-tune by working with a practitioner trained in Functional Medicine, who knows how to use nutrient supplements wisely.
  5. N-acetyl-cysteine (NAC): This amino acid is rich in sulphur that we need for detoxification and is a building block for a more complex molecule, Glutathione, which is a master-level anti-oxidant and detoxicant in humans. It is so vital for a healthy body, and so easily depleted due to the toxic environments in which we live, it makes sense to provide our bodies with what they need to manufacture it. NAC is readily converted into Glutathione in most people, is safe, and inexpensive. I recommend 600 mg taken twice daily with food.
  6. Curcumin: Derived from turmeric, this plant compound is profoundly anti-inflammatory and has been shown to be beneficial for many health conditions, including arthritis, allergies, vascular disease (including heart disease and stroke), autoimmune disorders, inflammatory bowel disease, mood disorders and neurodegenerative disease (like Parkinson’s disease and Alzheimer’s). Use a product that contains 200 mg of 95% curcuminoids from turmeric extract. To treat painful inflammation, use a minimum of 400 mg, working up to 2000 mg, taken 2-4 times daily. This is very safe supplement to use, so you should feel free to experiment with the higher doses if needed. Curcumin is a great substitute for the more dangerous anti-inflammatory drugs, such as Ibuprofen and Aleve.
  7. Magnesium: Another power-house nutrient that many people are deficient in. It is a vital mineral, used by the body for energy production, detoxification, neurotransmitter synthesis, and muscle relaxation. It should be a standard part of a good multi-vitamin-mineral supplement. It can be used as a stand-alone nutrient for those who are deficient, are experiencing muscle cramping, low energy, constipation or migraine headaches. Use magnesium that is chelated to glycine (magnesium glycinate) or other amino acids (malate, citrate, etc). Start with 100-200 mg at bedtime. Gradually work up the dose to bowel tolerance (magnesium becomes a stool softener at higher doses). Migraine sufferers may benefit from much higher daily doses–in the 1500-2000 mg range. For those who have kidney disease, consult with your healthcare provider before using.
  8. Protein: I certainly depend on daily protein supplements to support my daily requirements, which, quite frankly, are hard for me to get with food alone. I prefer non-dairy, non-grain sources of protein, such as pea protein and collagen hydrosylate (Great Lakes makes a good one that is made from grass-fed cows). I use it as an after-workout protein boost, 35 grams, and in the occasional smoothie that I concoct for a meal. I use the collagen for post-workout mixed in water. I use a combination of pea protein and collagen in my smoothies.
  9. Branched-Chain Amino Acids (BCCAs): These are specialized amino acids, found to varying degrees in all proteins, that stimulate muscle protein synthesis. This is an important attribute of our body’s response to movement and intense physical effort, that must be supported by adequate protein, and most specifically, BCAA intake. To be on the safe side, I add a scoop of BCAA to my post-workout protein supplement, or about 10 grams. Being able to adequately stimulate muscle protein synthesis is vital to good health, strength, and stability, and becomes increasingly important as we age, when our protein requirements actually increase.
  10. Digestive Enzymes: It has surprised me how many of us actually benefit from digestive support. A lot of our digestive dysfunction comes about from our fast-paced lifestyles, eating on the run or while working (I routinely eat lunch at my desk while working!). But there are also environmental and genetic factors that come to play. Sub-optimal digestive enzyme or hydrochloric acid levels will reduce the amount of available nutrition from our food, and may cause uncomfortable post-meal symptoms, such as excessive fullness, bloating, belching, or pain. Use one with a blend of pancreatic enzymes: peptidase, amylase, pepsin, protease, glycoamylase, lactase, lipase, invertase, and betaine HCL 200 mg (limit the betaine HCL to no more than 200 mg, unless you and your healthcare provider have ascertained that you need more–larger doses could cause a burning sensation). Start with one capsule no matter what the actual content in milligrams is. Gradually work your way up to several capsules, taken with a meal (any time during or right after), until you feel more comfortable. If you are still having issues, consult with your healthcare provider.

I’ve spent years vetting companies for the highest quality ingredients and good manufacturing practices. I’ll list my favorite companies for you. Most of these can be purchased through your Functional Medicine healthcare provider. You can also access the contact and ordering information for these companies through my Functional Medicine practice website, The Center for Medicine and Healing Artshere.

My Favorite Products:

  1. D3 5,000 or 10,000 by Metagenics or Designs for Health
  2. Ultraflora Spectrum by Metagenics
  3. Omegagenics EPA-DHA 720 by Metagenics
  4. DFH Complete Multi by Designs for Health
  5. N-Acetyl-Cysteine by Designs for Health
  6. C3 Curcumin Complex or Inflammatone by Designs for Health
  7. Magnesium Buffered Chelate by Designs for Health
  8. Collagen Hydrosylate by Great Lakes
  9. PurePea Unflavored by Designs for Health
  10. BCAA by Designs for Health
  11. Digestzymes by Designs for Health

 

Designs for Health

http://www.designsforhealth.com/

Xymogen

https://www.xymogen.com/

Metagenics

http://staging.nutri-dyn.com/ (midwest distributer for Metagenics products)

KARYN SHANKS MD

Karyn Shanks, MD, is a physician who lives and practices in Iowa City. Her work is inspired by the science of Functional Medicine, body-mind principles, and wisdom gleaned from the transformational journeys of thousands of clients over her twenty-five-year career. Her work honors each individual and the power of their stories, their inner wisdom, and innate healing potential. She believes that the bones of healing are in what we do for ourselves. She is the author of Liftoff, a manual of energy recovery and healing through essential self-care practices.

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