“Over the past fifteen years I’ve spent thousands of dollars on supplements, most of which had absolutely no effect on my symptoms.” Dr. Courtney Craig – Youtube video
To take or not take supplements is a big question in disorders like Chronic Fatigue Syndrome and Fibromyalgia where the list of FDA approved drugs is short (or non-existent) and not particularly impressive.
Where there are no drugs, though, there are always supplements – each purporting to be helpful – each suggesting it might provide the critical nutrient you need to turn your health around. Hope springs eternal with supplements and maybe it should. The supplement field – encompassing herbs, vitamins, minerals, neutraceuticals, probiotics, medical foods, etc. is enormous. With thousands of combinations available and new possibilities coming out regularly, supplements can potentially make a major impact on our health.
The very size of the field, though, makes the challenge of picking the right supplements and using them correctly a daunting one. It’s an area you can very quickly dump a lot of money into without results.
In this first part of a two-part blog we check out some of the supplement mistakes we all may have made in Dr. Courtney Craig’s video, “The Top Five Supplement Mistakes and How to Avoid Them”.
Then we talk further with Dr. Craig in order to flesh out the features of a effective supplement program.
Top Five Supplement Mistakes and How to Avoid Them by Dr. Courtney Craig
In this video Dr. Craig, a recovered ME/CFS patient, examines how to choose supplements that work, mistakes people make when taking supplements, and how to streamline your supplement regimen to save you money.
First she refers to an ebook by Dr. Charles Lapp and Dr. Bruce Shepherd that proposes that supplements for ME/CFS should meet three criteria before they recommend their general use by the ME/CFS population:
- It must be safe.
- There must be a scientific basis for its effects.
- It must cause a positive effect in at least fifty percent of those who take it.
Mistake #1 – You don’t need to take supplements if you eat a healthy diet
Soil depletion and other factors make it impossible to know if diet alone meets our nutrient needs. More importantly, perhaps, Dr. Craig asserts that the demands placed on the body by high levels of oxidative stress plus the immune system alterations and energy depletion found in ME/CFS suggests that supplementation is going to be needed.
Finally, with no FDA approved drugs available, Dr. Craig proposes that a smart evidence-based use of supplements may be the best way ME/CFS patients have of improving their symptoms.
The research on the need for supplements in Chronic Fatigue Syndrome is sparse, but what is there suggests supplementation can help.
Several studies have found, for instance, low levels of B-vitamins in ME/CFS patients. A 1999 study found low blood levels of vitamins B-1 and B-6. A 2014 study found that giving ME/CFS patients a multivitamin/multimineral supplement for two months resulted in an increase in antioxidant status (SOD) as well as significant reductions in fatigue, flu-like symptoms, sleep problems, autonomic nervous system symptoms, and headaches.
Mistake # 2 – All Supplements Are Created Equal – Brand Doesn’t Matter
Because the FDA does not regulate the supplement industry, supplement companies release products without federal oversight and unknown quality control. Independent testing to ensure that each supplement has the ingredients listed on its label is not required. Dr. Craig only uses supplements that carry one of three labels on the bottle that indicate it has passed a test by an independent agent that ensures the facilities that produce the supplement are adequate and/or that their supplements are pure and potent.
- Good Manufacturing Practices (GMP)
- NSF – National Sanitation Foundation
- USP – indicates the supplement is of pharmaceutical grade
Dr. Craig also states that, with little way to know how long they’ve been on the shelves, store-bought vitamins may have questionable potency.
She also suggests being on the lookout for fillers (including wheat gluten (!), cornstarch, eggs, nuts, dairy, shellfish and dyes) which companies sometimes add to supplements to increase their shelf-life and improve their presentation. These additives can cause problems for some individuals. If you have an allergy and are not sure what is in a particular product, contact the company.
Mistake #3 A Vitamin is a Vitamin is a Vitamin or the Right Vitamin, Wrong Form Problem
Vitamins come in many forms, some of which may not be particularly effective for you.
B-12, for instance, is usually either given sublingually or via injection in ME/CFS. It comes in four radically different forms: methylcobalamin, cyanocobalamin, hydroxycobalamin, and adenyosylcobalamin.
- Methylcobalamin – plays a role in the methylation cycle.
- Cyanocobalamin – is the most commonly found version of B-12 because it is the least expensive to produce, but it breaks down in the body to cobalamin and cyanide.
- Hydroxycobalamin – is believed to be useful for brain health.
- Adenosylcobalamin – is the least commonly found form of B-12,.adenosylcobalamin may be able to scavenge hydrogen disulfide, a byproduct of bacterial overgrowth in the small intestine (SIBO) – something commonly found in ME/CFS.
Co-enzyme Q10 (CoQ10)
CoQ10 is a potent antioxidant that plays an important role in producing ATP. [CoQ10 is one of the few supplements endorsed by virtually all ME/CFS practitioners]. It comes in two forms: ubiquinone or ubiquinol.
- Ubiquinone – is the oxidized form of CoQ10. The body has to transform ubiquinone back into its unoxidized form to use it.
- Ubiquinol – is CoQ10 In its biologically active ready-to-use form.
Folic acid, whether found in grain products or vitamins, has to be converted first into DHF and then into THF and then into 5-methyl THF before it’s ready to be used by the body. No less than three enzymes are needed to transform folic acid into its biologically usable form. A large portion of the population has genetic alterations to one or more of these enzymes that may inhibit this process, thus reducing the amount of folate available to the body.
That’s only the beginning of the problem, though. It turns out that unmetabolized folic acid has been implicated in the development of some cancers.
The take-home lesson is to always take active forms of vitamins in order to bypass potential problems in metabolizing them.
Mistake #4: Not believing that it matters when or how you take your supplements
Bioavailability refers to how likely the nutrient you take is going to be taken up by the body and be put to use. Several factors can affect it.
Taking nutrients on an empty or full stomach? Fragile nutrients that end up getting digested during a meal should be taken on an empty stomach. Probiotics and n-acetyl-cysteine (NAC), for instance, should always be taken on an empty stomach. NAC, in particular, is not cheap; i.e., it is not something you want to waste.
Foods – grains contain factors called phytates which act like a magnet to bind minerals before they can be absorbed. Taking a magnesium supplement with a phytate-rich meal will stop virtually all of the magnesium from being absorbed. Dr. Craig recommends taking mineral supplements on an empty stomach to ensure absorption.
Coffee and Tea – contain factors called tannins that also bind to minerals making them less bioavailable. In the presence of coffee, creatine absorption is also almost completely stopped.
More absorbable forms of supplements are continuing to be developed. Vitamin D, for instance, is poorly absorbed as a tablet, but is readily absorbed when emulsified as an oil.
Mistake #5 – Taking individual nutrients one at a time to see which one has an effect
Taking supplements one at a time to determine which ones work is often recommended, but Dr. Craig thinks differently. For one, taking single nutrients – i.e. pills that contain only one nutrient – can lead to a lot of pill taking, which is an expensive and rather complicated task. Dr. Craig reported she was taking 30-40 pills a day at one time.
Since ME/CFS is far too complex a disorder for one nutrient to have a major effect anyway, Dr. Craig recommends taking nutrients found in formulations that can provide synergistic effects. She pointed to an immune formulation called Immunitone that contains four different kinds of mushrooms and seven different herbs. You can either take tyrosine to support your adrenal glands or you can take an adrenal support supplement such as Adrenal Stress-End that contains all the adrenal support factors (tyrosine, licorice, vitamins, and adrenal factors).
Finally Dr. Craig noted that the supplements found on the online dispensary on her website fit the parameters for quality, synergism, and effectiveness outlined in this talk.
- Part II of Supplements and ME/CFS and FM: I’ve avoided supplements for years. In the second blog I explain why, lay out my criteria for engaging in a full-bore supplement program, and explore using supplements to combat ME/CFS further with Dr. Craig.
Dr. Courtney Craig D.C. was first diagnosed with CFS as a teen in 1998, and recovered in 2010 utilizing both conventional and integrative medicine.
- Check out Dr. Craig’s Health Rising blogs here