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Is the form of a supplement important?

March 23, 2017

The quick answer is yes. Absolutely. AND, we should always be looking first to spend our time and money on picking good foods high in the nutrients we are concerned about.

Food vs supplemetns

For minerals, I do prefer zinc picolinate. For calcium and magnesium, I always recommend chelated forms, and there are many (citrate, malate, aspartate, etc.). I don’t usually care which chelated form they take so long as there is no magnesium oxide or calcium carbonate in the product.

For patients with documented methylation defects (e.g. MTHFR 667, high or highish homocysteine, or a high normal MCV), I prefer that patients take a methyl-folate. Likewise, an activated methyl-B12 might be indicated over the conventional cyanocobalamine, if they have an MTRR SNP or clear issue with low B12. Likewise, with B6. The P5P form is further down the chain toward the active form. Do I always give these? No. Not unless indicated. They are expensive and more potent. I often give less of these activated forms than I would of the more conventional forms.

I am very picky when in comes to probiotics. On the flip side, for things like vitamin C, I don’t really care.

The list goes on. And on I am afraid. For practitioners, partnering with one or more professional supplement lines can help. But there is a very real risk of being drawn into a functional version of “pill for an ill” that is best avoided. To be doing more than “green allopathy”, all treatments must be based in diet and lifestyle changes with a judicious use of supplements and only when clearly indicated.

vitamin aisle

After years of doing this, many practitioners become connoisseurs of supplements. This is good, but it can lead to the over-prescription of supplements–especially when there is a profit incentive for the practitioner. This is something I routinely teach those new to naturopathic or functional medicine to avoid and guard against. When I inherit a patient from one or a line of other functional practitioners, I frequently end up taking them off of more supplements than I add. Lifestyle, lifestyle, lifestyle; there is no substitute.

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