this morning, my wife complained that "she is not a pill taker, can you make a patch?" My response was, "that's funny, just earlier today, someone complained that she wasn't getting enough pills!"  No one takes pills happily. Nor do we happily pay our taxes. We do it because we have to. If we don't take supplements, the chances are we will be taking pharmaceuticals (other pills), aging or feeling badly.

The debate over supplementation rages on. Since supplements work subtly and slowly, it is often hard to clearly discern their effect. Like building wealth for retirement, health accumulates and then, when we're older, we can tap into that asset. Does supplementation improve the quality and prolong the quantity of life??

There are quality scientific articles on nutrition from all over the world, indexed in pubmed.gov, the government database of medical articles. There are thousands of articles documenting significant deficiencies across the globe, including America. "Eating well" and eating organically can help, but there are factors that dominate these well-intended actions. The main cause of deficiency is mass food production. Toxicities make it worse.  

  There are extremely fit 80 year olds who physiologically act 60 or younger.  Whether it's the daily yogurt, coffee, whiskey, walk, music, or just good genes, we don't need research to state the obvious: if some people can do it, than many more probably can. 

A common notion is that "Americans have the most expensive urine". The argument is that we pee out excess nutrients. However, if we applied that concept to water, should we then reduce water consumption until we stopped peeing water? Creatures that can't pee die. So the role of water is to carry out other molecules that can not otherwise be excreted. The same is true of vitamins and minerals--they do work on the way in and the way out.

Many of the RDA's were set in the 1940's, after a series of nutrient deficiency  diseases (rickets, scurvy, pellagra) in the prior decades established the important role of specific nutrients. However, the levels set then were based on preventing these diseases. Getting the minimum of a nutrient has very different effects than getting the optimum amount. If we provide minimum, we get minimum. Same with children and plants.

To this day, we do not know optimum values. Population "norms" are just that--the norm of the population studied. If the whole population is prone to obesity or heart disease, then that's what the "normal" values will represent. Another layer is the individual biochemistry that each of us partly inherits and partly nurtures. Required intake of certain nutrients such as Vitamin D or Magnesium may vary by 10 times or more across the population.

If everyone in a population is deficient in a known nutrient, such as iodine, lithium or niacin, then this can not only affect their norms, but every other!  That's where we are, folks. What if epidemics of ADD, breast cancer, diabetes and depression were all 50% preventable with proper supplementation? This is what happened in the early 1900's with other nutrients. History is repeating itself, again. 

Simply stated, malnutrition means the nutrients are not getting into the mouth, while malabsorption means the nutrients are not getting from the gut into the body. Most of us have some of both. As discussed above, there is plenty of quality research showing global deficiencies of core nutrients. Malaborption is a huge topic, but in a nutshell the factors that can contribute to malabsorption include: chronic stress, medications, antibiotic use, and chronic stealth infections. In addition to malabsorption, the gut's ecology can affect brain, allergy, immune, hormonal and autonomic functions. 

Once you decide what you intend to take regularly, the next step is to figure out formats and brands. Studies regarding venue have not demonstrated a consistent winner. The incipients, coatings, and molecular forms of the nutrients all are involved. Two ways to "prove" absorption is by appropriate levels (serum, red blood cells, urine, other) and/or by a consistent positive clinical response. 

Due to concerns about toxicity (such as with Vitamin D) and competition (such as between O3 and O6 oils), levels are always  preferred. The cost often offsets the losses involved in taking the wrong levels for months at a time. 

It is getting easier. The comfort and incorporation of supplements into a lifestyle will grow in importance as the costs of health care increase. Prevention is always cheaper than correction. 

1. This educational material may not be used to influence medical care without supervision by a licensed practitioner.

2. These contents are ©2017 by Michael Cheikin MD and may not be reproduced in any form without express written permission.

3. Dr. Cheikin's website has related articles such as "Food Plans", "Frankenfoods", "Leaky Gut Syndrome" and others.