Dietary Supplements: Needed or Not? (cont.)

MEMBER QUESTION:
When taking calcium supplements you hear that it should be taken with vitamin D or magnesium to be absorbed properly by the body. Is this true for other types of vitamins that need to be taken conjunctly with another vitamin for better absorption?

DORFMAN:
There are many nutrient interactions, but in general nutrients are best taken with food because that's where they're found. Without going into a long lecture of all the nutrient interactions, my philosophy is that consistency is 9/10 of the law and taking your calcium with magnesium and vitamin D on a consistent basis is the most important thing.

MEMBER QUESTION:
Is the supplement 5-HTP safe?

DORFMAN:
5-HTP stands for 5-hydroxy tryptophan. Tryptophan is an amino acid. The body uses tryptophan to make the neurotransmitter serotonin. Normally you start with tryptophan that converts to 5-HTP, and then it is converted in the next step to serotonin. So you use 5-HTP to enhance serotonin for this reaction.

Years ago there was a contamination problem with tryptophan supplements and they were withdrawn from the market. They are now back as 5-HTP, and there have not been any contamination issues. The company that caused the tryptophan problem is now out of business, and there's no reason to think that 5-HTP will have the same problem.

The only problems associated with taking 5-HTP would be, in theory, those that would result from improperly increasing serotonin. So you must be sure that your doctor knows you're taking it, especially if you're taking serotonin-altering drugs, such as Paxil or the other SSRIs.

MEMBER QUESTION:
What is the difference between SAM-e and 5-HTP? Which is more effective for depression?

DORFMAN:
It depends on what the chemical basis of the depression is. Unfortunately, our technology for unraveling that is somewhat primitive, so mostly we use trial and terror. So 5-HTP works better for some, and SAM-e will work better for others.

MEMBER QUESTION:
Could you explain further your comments about taking raw materials to improve production of estrogen, etc.?

DORFMAN:
Estrogen is made from cholesterol, and most people are trying not to eat too many cholesterol-laden foods these days, but they are built on fats. So balancing fats may be useful in optimizing estrogen production later in life.

The adrenal glands are responsible for secondary estrogen production after menopause and they produce steroid hormones also, but many women in our culture stress their adrenal glands with busy, stressful lives. Sometimes this becomes more noticeable as we age and these glands aren't as flexible any more.

MEMBER QUESTION:
Do you recommend a person have a blood test that would specifically measure vitamin and mineral levels and check for deficiencies? It seems it is only when one has symptoms that one looks to supplement one's diet. I would like to know where I stand in order to minimize any nutritional deficiencies.

DORFMAN:
If only there were a test that could do that easily we'd all be ordering it, but there isn't a simple test. Part of the reason is because of the wide range of bio-individuality. So a level that would be normal for one person might be too low for the next.

The best vitamin tests are expensive, so to find an inexpensive broad test to look at a number of factors is pretty tough. Besides, those tests tend to only find severe deficiencies, and the question is whether you're trying to treat severe deficiency or optimize health. The "optimize health" situation is much trickier, but hopefully that's where most of us are operating. Most of us, at worst, have marginal deficiencies and they're hard to find with even the best tests. So that's why general nutritional supplements can be so useful.

MEMBER QUESTION:
I read where a taking garlic supplement is good for high blood pressure and lowering your cholesterol. Does it really work?

DORFMAN:
There were actually a number of studies that found garlic could be useful in part of a balanced program for controlling hypertension and lowering cholesterol. It's certainly safe enough.

MODERATOR:
Do you have any final words on choosing and using supplements for us, Kelly

DORFMAN:
I think that supplements can be used safely by most people without undue concern. You can make yourself toxic with nutritional supplements, but generally you have to work at it. The most important concern is the potential interaction with the more obscure supplements such as 5-HTP and medication.

One other important piece of information: If you are taking fish oils to lower heart disease risk you need to stop them one week to 10 days before any surgery, because they tend to increase bleeding time, which is good for lowering heart attack risk, but bad when you're recovering from surgery. They can be resumed 10 days after surgery if it's OK with your doctor.

MODERATOR:
Thanks to Kelly Dorfman MS, LN, LD, for sharing her expertise with us.

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