This week, by popular demand, we’re diving into the world of supplements. It’s Dr Tom’s turn to open up the medicine cabinet and spill the... er... pills!
Bottom line: we mostly shouldn't need them
There are very few vitamins or mineral supplements that medical opinion universally recommends. The list comes down to:
Vitamin D in the winter months (yes, we’re that sun-starved in the UK), and
Folic acid for women who are, or could become, pregnant.
The official advice is that if you're healthy and eating a varied, balanced diet, rich in fresh fruit and veg, and other minimally processed foods, your nutritional needs should already be covered.
In that case, handing over your hard-earned cash to supplement companies might just result in expensive pee. Or in the case of the fat soluble vitamins, A, D, E & K, these actually build up in your system, so extra caution is advised against mega dosing- more is not always better.
Beware the self-treat or lucky dip approach
If you have symptoms that make you suspect a deficiency, please don’t start by lucky-dipping your way through Holland & Barrett.
Common symptoms that supplement companies love to target, like fatigue or skin issues, can have many possible causes. So your first stop should be your doctor for a proper check-up, relevant tests, and to rule out anything more serious.
If a deficiency is confirmed, yes, treatment might involve simple supplements. But sometimes the real issue lies elsewhere. For example:
B12 deficiency might not be down to your intake. it could be that your body isn’t absorbing it properly, in which case your doctor will need to prescribe injections
Iron deficiency/anaemia might stem from diet, but could also be due to heavy periods (in women) or even hidden blood loss, which deserves proper investigation.
So where’s the middle ground?
What about the rest of us bobbing along in that middle space, feeling “basically OK,” but wondering if things could be better? And let’s face it, how many of us actually hit that ideal diet 100% of the time? Or even 80%?
There are so many factors that can derail our efforts:
- time to prepare (or even defrost) that home cooked meal,
- time to shop regularly for those super fresh, nutrient dense ingredients,
- having the discipline to eat them before they go slimy (when after the day you’ve had, curling up on the sofa with cheese and biscuits is so much more appealing)
Also, there are many scenarios in which we simply don’t have full control over our menu such as when travelling or entertaining for business. And spare a thought also for those battling to cater for a crowd and their various ‘likes and don’t likes’. Small wonder that many of us then end up stuck with a limited repertoire of crowdpleaser dishes ‘on rotation’. At least it keeps the peace!!
A case for a little supplementation
Given all that, we think there’s a reasonable argument for moderate daily supplementation as a sort of nutritional insurance policy. This isn’t about spending a fortune or mega-dosing. It’s a sensible, low-risk “each-way bet”, at levels that you might reasonably find in actual food. And yes, it helps us feel a bit better about the odd night of cheese and crackers on the sofa!
Dr Tom’s daily supplement regime:
1x Multivitamin/mineral – an A–Z with around 100% of the UK RDAs for most things. No megadoses.
1x Magnesium supplement – around 100% of the RDA (most multis don’t contain enough).
1x Vitamin D – at least 400 IU (check if this is already in your multivit).
1x Omega 3 fish oil – because oily fish is not a big hit in the Willsher household.
Wishing you all a great week,
Dr Tom, Gemma and all at Winchester GP
P.S. If your diet is routinely more beige than balanced, that’s your starting point, rather than supplements- getting back to “mostly good” should be the priority. Kaye Osborne is our go to for in depth nutritional guidance and if behavioural or psychological challenges are the main barrier Kate Houldsworth is an excellent source of real world behavioural strategies and tactics