Supplements and Vitamins

[Marbles]

I’d be interested where you read that fish oil supplementation doesn’t decrease cardiovascular risk. Everything I’ve read says the opposite.

Here is a decent discussion. The STRENGTH trial is the basis.

Omega-3 fatty acids and the heart: New evidence, more questions - Harvard Health

Omega-3 fatty acids from fish and fish oil have been recommended by the American Heart Association for the past 20 years to reduce cardiovascular events in people who already have cardiovascular di...

www.health.harvard.edu

One could say my statement was correct, incomplete, or wrong, depending on how you want to argue it.

Personally I don't consider Vascepa a fish oil supplement, but rather a pharmaceutical.

 

[Marbles]

I'd be interested in folks who share providing some basis for their experience or opinion. This is an interesting topic, where one person could be a MD specializing in this field, and another just a knuckle dragger like me.

Well, evidence should speak for itself. The fact that I'm an adult acute care nurse practitioner working in cardiology and educated at Georgetown University should not mean should get a pass on having to have data.

 

[fwafwow]

Well, evidence should speak for itself. The fact that I'm an adult acute care nurse practitioner working in cardiology and educated at Georgetown University should not mean should get a pass on having to have data.

Well said. There are plenty of historical situations in which the experts in the field in question, including medicine (and even by consensus) have been wrong. BUT, the fact that you are a health care professional who also both provides underlying data, and is willing to concede when you may be wrong.

I will review both the Harvard link and the fish oil link posted by @aftriathlete and revert. The last time I investigated this it seemed (IIRC) that any benefits from Omega-3 was based on epidemiology studies (surveys) of people who ate fish - not supplements. But I could be mistaken, and/or the evidence has evolved.

EDIT - if not already obvious, I am also a knuckle dragger (in medical terms - I've always been a civilian).

 

[Team4LongGun]

Well, evidence should speak for itself. The fact that I'm an adult acute care nurse practitioner working in cardiology and educated at Georgetown University should not mean should get a pass on having to have data.

I agree-but if you laid carpet for a living, one could extrapolate your exposure to, and understanding of said studies would be different.

 

[fwafwow]

Sort of. There are many very good medications that most people would have trouble finding or understanding the evidence that shows they are good.

Noted and agreed. IMHO the difference (or at least a difference) is that many medications require a subscription from a medical professional, who presumably is in a better position to find the evidence. (And if they are OTC, at one point they may have previously not.) The decision to take supplements or vitamins (let me just call them supplements from here on) seems to normally require much more from the consumer - so my preference would be for those who stand to benefit most from supplements (in my opinion the makers) could provide the evidence in a way more easily digested by the lay persons taking them. The fact that they don't (unless I'm unaware of some resource - a problem in itself), to me at least suggests they made a conscious decision as opposed to just being apathetic. Whatever the reason, I'm not a fan.

There are many commonly accepted truths (to include in medicine) that have nothing but a hypothesis to support them.

I try to stay with the evidence, but sometimes there is not good evidence and a hypothesis is the best one has. As long as you know the weakness of that, it is fine to run with it untill better data is available.

Agreed.

There may be supplements worth pursuing, but having failed to find one I have stopped looking as it is a low yield area.

Exactly this for me. The upside of one working (and to what extent) is offset by a corresponding downside. I figured I was wasting more time researching stuff and could just try to focus on eating better. I have failed at both.

Example, supper beats clearly low BP, however not everything that lowers BP improves long term outcomes. Most likely it is the nitrates in the beats, nitrates (without a specific reason to use them such as angina) are not associated with improved outcomes. So, if I'm going to need BP meds I would personally opt for the cheaper ARB (such as losartan) than the more expensive and unproven supper beats. In the end, I really care only about the improved long term outcomes, not a number (other than to the extent the number helps me get to the outcome).

I spend a lot of time taking people off beta-blockers (BB) if the BB is only for blood pressure. While BBs get the number down, if there is not another reason for BBs, they don't improve outcomes. So, they treat the number, not the patient in the case of blood pressure.

Because BBs do a good job treating the number they once were first line therapy for BP control and are still prescribed for it commonly. The hypothesis was legitimate, but did not stand up to investigation.

There are very good reasons to use BBs though, and suddenly stopping can be dangerous, so no on should stop them without involving a healthcare provider.

Ugh. This hits close to home with aged parents. (Longer boring story redacted.)

 

[Mike Islander]

Noob question here. What’s the deal with supplements and vitamins? I’m wondering how much of this stuff can my body actually absorb? How much of it improves health and how much is snake oil?

I’m 38 years old, having never took anything like that in my life. I started taking a wilderness athlete multi vitamin and I can feel a difference. I actually feel better.

Now I’m looking at more supplements and more expensive vitamins, but not completely sold on it.

Boy they will sell me a handful of pills to take every day but dang that’s a lot for my body to deal with. I’m thinking it’ll give me kidney stones or something!

Any advice?

Have your wife or friend put fake ones and real ones into capsules. Take one set for a month and then real ones for another month (not knowing which is which). See if this feeling is causal or placebo. Literally the only way to know if it's actually doing anything for you. Could save you tons of money.

NIH.gov has tons of peer reviewed studies on supplements and vitamins that do this type of double-blind, placebo-controlled test with hundreds or even thousands of people. Not much evidence for SIGNIFICANT benefits of vitamin pills for those with a good diet.

 

[fwafwow]

There’s a lot here on fish oil benefits.

FoundMyFitness Topic - Omega-3 fatty acids

Omega-3 fatty acids play critical roles in human health and may be beneficial in ameliorating symptoms associated with chronic health conditions and in combating aging-related diseases.

www.foundmyfitness.com

Thanks for posting a source. OK - I admit that I initiated a search (for "fish oil") first, rather than a complete read of the article. Here are my initial observations/questions based on that search:

1. This was interesting -
   • "Findings from a clinical trial suggest that omega-3 fatty acid supplementation increases blood levels of SPMs up to 24 hours after ingestion. The double-blinded, placebo-controlled, crossover study involved 22 healthy volunteers between the ages of 19 and 37 who took a fish oil supplement enriched in omega-3 fatty acids. At two, four, six, and 24 hours after taking the supplement, participants provided blood samples for analysis, which revealed a time- and dose-dependent increase in blood SPM levels that persisted for up to 24 hours." (Text accompanying fn. 49.)
   • To me 22 participants seems pretty small, maybe even statistically too small. But I don't know what SPMs are, or whether (and to what extent) having them in one's blood impacts a person, and whether it is good, bad or mixed. I guess I need to go down that path.
2. There's more, but I'd hate to kill the thread (apologies already to the OP) by too much boring stuff.

 

[fwafwow]

Here is a decent discussion. The STRENGTH trial is the basis.

Omega-3 fatty acids and the heart: New evidence, more questions - Harvard Health

Omega-3 fatty acids from fish and fish oil have been recommended by the American Heart Association for the past 20 years to reduce cardiovascular events in people who already have cardiovascular di...

www.health.harvard.edu

One could say my statement was correct, incomplete, or wrong, depending on how you want to argue it.

Personally I don't consider Vascepa a fish oil supplement, but rather a pharmaceutical.

I see why you are saying correct, incomplete or wrong. I'm not sure yet - and it seems like this will take a considerable portion of my rabbit hole budget (which, by the way, is strong, to quite strong).

The STRENGTH trial reference was interesting enough for me to read at least the beginning. The abstract was a roller coaster. First, the summary seems bad for supplements - and it's got lots of participants, double-blind - all seem legit. But wait, they stopped the study early, that's not always a good sign. (I found this subsequent gem in the report: "A greater rate of gastrointestinal adverse events was observed in [by the supplement takers].") Then I see the massive list of conflicts of interest. (At least they are disclosed.) Ugh.

Not sure what to think, except to get myself more comfortable on my gut reaction would take lots more time, so I'm going to stick w/ my somewhat informed gut reaction opinion. But it may just be a rabbit hole I set aside for another day.

Cheers!

 

[Gseith]

Sometimes I wonder if everything I take is helping me or wasting money. I try to keep a healthy diet and strength train 3-4 times a week.
I take Creatine, fish oil, vitamin d, and a super green powder every morning. I also take whey protein after I work out.
I feel good so I just keep doing the same. Been on the same routine for about 2 years now.

 

[Highvoltage1]

I took tumeric as a supplement for a while when dealing with Lyme and then got away from it. I started feeling achy and sore often due to work and normal exercise. Within the last week I began taking it again and I feel all of those issues went away and I feel so much better. I’m not claiming anything other than it helps me. Best wishes

 

[westonhoma]

Watch/ listen to Dr Andrew Huberman, Dr Mile isratael and Dr layne Norton for no BS science backed and peer reviewed info on supplements, dosing and snake oil bs. Those 3 are probably the most straight shooters out currently


Sent from my iPhone using Tapatalk

Idk much about Isratael but Huberman and Norton are really the only people I really trust when it comes to fitness/health advice. Another good one is Dr Andy Galpin. Check out the series of podcasts he did with Huberman for endurance/strength training and nutrition

 

[westonhoma]

Also I do a lot of endurance training (marathons/ultra marathons) as well as strength train. Daily fish oil & Mens One-A-Day (you get more out of the pill vs the gummies) have helped me greatly. I dont buy the most expensive stuff either. For example, if you do a side by side label comparison of AG1 vs the Mens One-A-Day capsule, they pretty much are the same things per serving and the capsule is drastically cheaper. (Ag1 includes some gut health stuff that Mens-One-A-Day doesnt but other than that they are very much similar)

 

[Szwampdonkey]

Get blood work and go from there. I was EXTREMELY low in Vit D which really surprised me as I pretty much live outside and get plenty of sun, too much probably. Despite that i was super low where the Doc put me on High Dose Vit D for a few months.

It can indeed have consequences too such as nerve conduction issues, mood issues, fatigue, insomnia etc so it does matter.

I do think just taking a daily multivitamin off the shelf is a waste of money.

 

[mtbraun]

Get blood work and go from there. I was EXTREMELY low in Vit D which really surprised me as I pretty much live outside and get plenty of sun, too much probably. Despite that i was super low where the Doc put me on High Dose Vit D for a few months.

It can indeed have consequences too such as nerve conduction issues, mood issues, fatigue, insomnia etc so it does matter.

I do think just taking a daily multivitamin off the shelf is a waste of money.

Agree, the OP has no baseline data to go from, so jumping right in to the "popular" supplements is a waste of money at best, potentially harmful at worst. Get bloodwork and a battery of other tests done to see what your body really needs.

 

[BBob]

A long time ago I proposed the same question to my doc. He said let’s look at bloodwork. No deficiencies so he said he didn’t see any need for supplements just keep eating well like you already do. He’s a personal friend, athlete, hunter so he knows me well.

So after many years of chasing performance food fads and supplements I quit and just eat a good clean varied diet. I can’t honestly say that anything from that past really helped my performance other than working hard at training and eating well. I’m still chugging along keeping up with or exceeding lots of the kids around me just eating food.

I’ve been looking into cholesterol drugs (statins) lately. I seem to find studies showing that although they do reduce cholesterol on the front end the end results don’t seem to improve outcomes much at all with the big downsides of side effects for many. So do you take a drug that looks like it’s doing something but in the end statistics may not back the claims?

 

[Mike Islander]

A long time ago I proposed the same question to my doc. He said let’s look at bloodwork. No deficiencies so he said he didn’t see any need for supplements just keep eating well like you already do. He’s a personal friend, athlete, hunter so he knows me well.

So after many years of chasing performance food fads and supplements I quit and just eat a good clean varied diet. I can’t honestly say that anything from that past really helped my performance other than working hard at training and eating well. I’m still chugging along keeping up with or exceeding lots of the kids around me just eating food.

I’ve been looking into cholesterol drugs (statins) lately. I seem to find studies showing that although they do reduce cholesterol on the front end the end results don’t seem to improve outcomes much at all with the big downsides of side effects for many. So do you take a drug that looks like it’s doing something but in the end statistics may not back the claims?

Congrats on good health through food and action.

Statins? Last resort. Personally I'd work out 7 days a week and eat nothing but sawdust (if that worked) before I'd get on a Statin drug, or many many other powerful drugs.

 

[fwafwow]

I’ve been looking into cholesterol drugs (statins) lately. I seem to find studies showing that although they do reduce cholesterol on the front end the end results don’t seem to improve outcomes much at all with the big downsides of side effects for many. So do you take a drug that looks like it’s doing something but in the end statistics may not back the claims?

I went down this rabbit hole during Covid when I had lots of time on my hands. To answer your question - personally - no. Based on my memory, the studies show that statins can reduce overall mortality only for those who have already had a heart attack. For those who have not, the cholesterol might be lower, but not overall mortality. If you locate anything to the contrary, I'm all ears.

 

[Mike Islander]

I went down this rabbit hole during Covid when I had lots of time on my hands. To answer your question - personally - no. Based on my memory, the studies show that statins can reduce overall mortality only for those who have already had a heart attack. For those who have not, the cholesterol might be lower, but not overall mortality. If you locate anything to the contrary, I'm all ears.

Yep. And cholesterol's role in CHD is now being questioned as well. Partly responsible for this questioning was that statin patience had lower cholesterol but didn't die any less often. So the cholesterol level itself was not a significant determinant of increased death rate.

 

[*zap*]

you can go down a rabbit hole with this stuff...best to make good decisions.

read the ingredient list on protein powders..

 

[fwafwow]

Yep. And cholesterol's role in CHD is now being questioned as well. Partly responsible for this questioning was that statin patience had lower cholesterol but didn't die any less often. So the cholesterol level itself was not a significant determinant of increased death rate.

Agreed. But I didn't want to open too many cans of worms. To tell people that cholesterol may not cause heart disease could be a bit too much for many.