“To supplement or not to supplement”, you ask yourself…

iStock_000016784572XSmallBeginning a dialog about taking vitamin supplements should be prefaced by stating that you should first and foremost, get nutrients from food whenever possible. Humans are adapted to getting nutrients from whole foods. Most nutrients require enzymes, synergistic co-factors and organic mineral-activators to be properly absorbed. While these are naturally present in foods, they are often not included in synthetic vitamins with isolated nutrients. This concept of “food synergy” cannot be over-stated in that there is an interrelationship between the constituents in foods that cannot be replicated in a vitamin supplement. In a paper published in the American Journal of Clinical Nutrition called Food Synergy: An Operational Concept for Understanding Nutrition emphasizing the importance of obtaining nutrients from whole foods, the authors concluded:

“A person or animal eating a diet consisting solely of purified nutrients in their Dietary Reference intake amounts, without benefit of the coordination inherent in food, may not thrive and probably would not have optimal health.”

The fact is, 95% of the multi-vitamins on the market are produced by pharmaceutical companies, who use the cheapest raw materials possible. These mass-produced vitamins are made from either synthetic chemicals or “isolated” food fractions. For instance, the legal definition of vitamin C is “ascorbic acid.” Yet ascorbic acid is but a single, isolated portion of the whole vitamin C complex. In nature, vitamin C always appears as a combination of substances in addition to ascorbic acid that includes bioflavonoids, rutin, and organically bound copper in the form of the enzyme tyrosinase. Tyrosinase is the activating portion of the C complex, with bioflavonoids and rutin are synergists that keep blood vessels strong and prevent bruising. The ascorbic acid portion merely protects these functional parts from oxidation. It is as a peel is to a banana. Yet Vitamin C in the form of ascorbic acid is sold as though it is the whole vitamin complex. This is the case with many vitamins purchased from your local health food store.

Multivitamins are used by approximately half of Americans currently. But there is plentiful evidence that this may not be such a good idea. Most studies show that multivitamins either provide no benefit, or may even cause harm. A study in the Archives of Internal Medicine showed that multivitamins have little to no influence on the risk of common cancers, CVD or total mortality in postmenopausal women. A now infamous meta-analysis in the Journal of American Medical Association, which looked at over 68 trials with 230,000 pooled participants, found that treatment with synthetic beta carotene, vitamin A and vitamin E may increase mortality.

Another problem with multivitamins is that they contain too little of beneficial nutrients like magnesium, vitamin D and vitamin K2, and too much of potentially toxic nutrients like folic acid, calcium, iron and vitamin E. This means that multivitamins can actually cause nutrient imbalances that contribute to disease.

While multivitamins have little benefit, individual supplements generally improve health. In an Iowa Women’s Health Study nine of twelve supplements studied decreased mortality rates. Because of flawed multivitamin formulas, they are not the best way to relieve nutritional deficiencies. A strategy of eating more nourishing foods and supplementing individual nutrients has a better chance to achieve optimal nourishment. Some nutrients are difficult to obtain enough of from food alone. There are also circumstances where our need for certain nutrients may increase, such as vitamin C (whole complex) during infections and magnesium with blood sugar imbalances or metabolic problems. In these types of cases, it makes perfect sense to supplement selectively with beneficial nutrients.

That being said, lets take a look at the individual Vitamins I recommend people supplement with.

Vitamin A (Retinol)

Vitamin A is an important catalyst for a variety of biochemical processes in the body. It’s required for assimilation of protein, minerals, and water-soluble vitamins, and it also acts as an antioxidant, protecting the body against free-radical damage and diseases like cancer. Vitamin A plays a crucial role in reproduction, promoting full-term pregnancy and proper development of the face (eyes, nose, dental arches & lips).

Vitamin A is only found in significant amounts in organ meats, which explains why many Americans don’t get enough of it. If you do eat organ meats (especially liver), you’re probably getting enough vitamin A and thus don’t need to supplement. If not then you’ll probably benefit from supplementing with A.

There has been considerable discussion about the toxicity of vitamin A, but this is only caused when there is a deficiency of vitamin D. Therefore, it is important to be sure to take vitamin A in conjunction with vitamin D. This is why cod liver oil is such a great supplement. It contains the perfect ratios of vitamin A and vitamin D which negates the toxicity present when taken alone. Cod liver oil is really more of a food than a supplement, but since it’s not a normal part of people’s diet we’ll consider it as a supplement. Cod liver oil is an ideal vitamin A source for this reason.

Vitamin D

This is perhaps the most talked about vitamin the past several years for a few good reasons. Number one, most people are deficient in it. Number two, it’s absolutely critical for health. We can get vitamin D from two sources: food, and sunshine. Seafood is the only significant source of vitamin D, but you’d still have to eat a ton of it to get enough.

Vitamin D deficiency is extremely damaging to Americans’ health. It contributes to the following diseases:

  • Cancer – The farther north one lives (and consequently less sun), the more likely one is to die of cancer. The simple step of optimizing vitamin D levels could cut U.S. cancer rates in half.
  • Cardiovascular disease – Levels of vitamin D predict who will die of stroke: the lower the vitamin D level, the more likely a fatal stroke will occur.
  • Mortality rates – People with higher vitamin D levels are less likely to die of any cause.
  • Diabetes – Higher vitamin D status is associated with lower rates of diabetes.
  • Dementia – Vitamin D is highly effective in improving cognition in Alzheimer’s patients.

Getting sunlight alone isn’t a sufficient enough source of vitamin D. It’s important to have your vitamin D levels checked by your doctor. As with vitamin A, the best source of vitamin D is a high quality cod liver oil (I recommend Green Pastures fermented cod liver oil). It contains not only vitamins A & D, but omega 3, natural vitamin E, and other quinones. The importance of having adequate levels of vitamin D can not be overstated.

Vitamin K2

Vitamin K2 is the most important vitamin most people have never heard of. It’s needed to activate proteins and it also regulates calcium metabolism (keeping it in the bones and teeth where it belongs, and out of the soft tissue where it doesn’t belong). Elevated blood calcium significantly increases the risk of cardiovascular disease (CVD) which explains why vitamin K2 has been shown to prevent atherosclerosis and heart attacks. It also strengthens bones. Without vitamin K, blood doesn’t clot, leading to hemorrhage; bones don’t calcify properly, leading to fractures; and cancer runs rampant.

Unfortunately, many, if not most of Americans are deficient in vitamin K2. The consequences of Vitamin K2 deficiency are quite serious:

  • Loss of bone strength
  • Atherosclerosis and heart disease
  • Mortality rates increased – supplementation reduces mortality rates 26%
  • Increased cancer rate – K2 is a companion to vitamin D and is very effective against cancer
  • Reduced neurological and cognitive function

I recommend eating vitamin K-rich foods such as green leafy vegetables, organic butter and cream, fermented vegetables, aged cheese, liver, and egg yolks and supplementing. Available supplements are bacterial-produced MK-7, available in 100-microgram doses.

Vitamins A, D, and K2 are fat-soluble vitamins that collaborate in many functions and exist in a synergistic relationship. It is extremely important to supplement with all of the fat-soluble vitamins together.


Magnesium is perhaps the most important mineral essential for good health, yet most Americans are deficient in it. More than three hundred enzymes need it, including those needed to make the energy molecule ATP and to synthesize DNA, RNA, and proteins. Magnesium also plays an important role in bone and cell membranes, where it helps transport ions across the membrane surface.

Magnesium is difficult to obtain from food and most multivitamins do not contain enough magnesium to meet the daily requirement. Another issue is that magnesium levels in food have dropped as modern soils have become increasingly depleted. So if you are not supplementing, you are simply not getting enough.

Magnesium deficiency can be fatal. Symptoms of acute magnesium deficiency include muscle cramps, heart arrhythmias, tremor, headaches, and aid reflux. It is associated with CVD, hypertension, metabolic syndrome, diabetes, migraines, PMS, asthma,  and hypothyroidism. In fact, its hard to find a modern disease magnesium deficiency isn’t associated with.

Therefore, I recommend that everyone should supplement with magnesium. I recommend between r00-800 milligrams daily. Taking too much can cause loose stool, and in fact can be an effective component in those with constipation issues. Magnesium Glycinate the chelated form of magnesium, is the preferred type due to its better absorption.

Vitamin C

Vitamin C is one of my favorite vitamins and is needed for the manufacture of body components:

  • Collagen, the scaffolding on which all organs, bones, and tissues are built
  • Carnitine , which transports fats into mitochondria for energy production
  • Norepinephrine and epinephrine (adrenaline), hormones and neurotransmitters that control alertness, arousal, and motivation
  • Enzymes involved in the creation of peptide hormones, tyrosine metabolism, and bile acid

Vitamin C is also needed to maintain levels of glutathione, the immune system’s primary antioxidant. Symptoms of vitamin C deficiency may include a tendency toward cavities or fractures, hair or tooth loss, bruising, bleeding gums, muscle loss or difficulty gaining muscle, slow wound healing, and joint pain and swelling. Severe vitamin C deficiency results in death unless remedied.

Clinical trials have found benefits from extra vitamin C. High-dose vitamin C supplements can significantly reduce mortality, especially cardiovascular mortality:

  • The First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study found that among those supplementing with vitamin C to achieve a total intake of 300 milligrams per day or more, the risk of death from all causes was decreased 35% in men and 10% in women. Men who took 800 milligrams per day of vitamin C lived six years longer than those consuming only the recommended daily allowance.
  • The Nurses’ Health Study which followed the health of 85,000 women over sixteen years found that vitamin C supplementation was associated with a 28% lower risk of heart disease.

Unfortunately, the vitamin C purchased today is not the whole vitamin C complex, but merely the ascorbic acid component. Look for a whole food vitamin C complex such as the one offered by Standard Process Co. I recommend 1,000 milligrams of buffered Vitamin C daily.

Supplements to avoid:


Calcium has become one of the most popular dietary supplements on the market, particularly among older woman, in the hope that it might prevent osteoporosis. Huge doses, sometimes as high as 1,200milligrams per day, have been recommended.

Unfortunately, it looks as though high-dose calcium supplementation was a mistake. It turns out calcium supplements don’t do much to improve bone health. They don’t clearly reduce fracture rates in older women and might actually increase the rate of hip fractures. In people with normal vitamin D levels there is no benefit to calcium supplementation.

But worse than that studies have consistently found that supplemental calcium increases the incidence of strokes and heart attacks by over 30% and increases the overall risk of death by 9%. One analysis concluded, “Treating 1,000 people with calcium or calcium and vitamin D for five years would cause an additional six myocardial infarctions or strokes and prevent three fractures.” Heart attacks and premature death aren’t the only risks from calcium supplementation:

  • Calcium intake is associated with brain lesions in the elderly
  • In the Nurses’ Health Study, supplementation of calcium increased the risk of calcium oxalate kidney stones by 20%
  • Calcium promotes the formation of biofilms and can aggravate infections

It has become clear that calcium balance occurs at an intake of 741 milligrams per day. Anything above this intake the body tries to excrete. This amount can readily be obtained from food. Green leafy vegetables and dairy products are good sources of calcium, but the best way to obtain calcium is from bone broth soups.

Folic Acid

Folic acid that is found in most multi-vitamins is not naturally occurring folate, but a compound not normally found in food or nature. While folic acid can be converted into folate, that conversion is poor in humans. It’s also important to note that unlike natural folate, folic acid does not cross the placenta. This is significant because folate is a crucial nutrient for pregnancy, and while folic acid can prevent neural tube defects it doesn’t have the other beneficial effects of folate. What’s more, several studies have suggested that folic acid – but not natural folate – may increase cancer risk!It is significantly cheaper than natural folate which may explain why it is in multi-vitamins

In addition:

  • Supplementation with folic acid during pregnancy leads to higher rates of wheezing and asthma in children. In mice, folic acid during pregnancy gives the pups asthma.
  • The correlation between use of prescription prenatal vitamins containing 1 milligram folic acid and autism is 87%.

The mechanism of toxicity from folic acid are not fully known. The body doesn’t completely convert synthetic folic acid to natural folate, and it is thought that low levels of circulating folic acid may be responsible for the ill effects. Whatever the case, it may be wise to avoid folic acid, especially for pregnant women.

Calcium and Folic acid are contained in virtually all multi-vitamins which is another good reason to avoid multi-vitamins.


Yours in health,

Rick J Bernard

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