Are supplements really necessary?

134086693In a perfect world, the answer to this question would be “no”. In the world most of us inhabit, I believe the answer is often “yes”. This might seem inconsistent with the Paleo approach. After all, our ancestors weren’t popping pills to stay healthy, so why should we?

Our modern environment is profoundly different than that of our ancestors. In fact, a fundamental tenet of the ancestral health movement is the recognition that we are “mismatched” with our current environment in numerous ways, and it is that mismatch that is responsible for the modern disease epidemic. Examples include:

  • A decline in soil diversity and quality (and consequent decline in nutrient density of foods).
  • A decrease in diversity of plant species consumed.
  • An increase in exposure to food and environmental toxins.
  • Overuse of antibiotics, birth control and other medications (damaging the gut and liver).
  • An increase in chronic stress.
  • A decrease in sleep quality and duration.
  • A reduced connection with nature and less time spent outdoors.
  • A move away from the tight-knit social groups that were the norm for humans until very recently (and the resulting effect on our nervous system).
  • An increase in the number of hours we spend sitting.

Maintenance vs. therapeutic supplementation

Since I started writing this blog, I have argued for obtaining as many nutrients from food as possible. Humans are adapted to getting nutrients from food, and foods contain many co-factors and enzymes required to absorb those nutrients. However, I have also stated from the beginning that certain nutrients are difficult to obtain even in the context of a healthy diet (such as vitamin D and magnesium), and supplementing with them indefinitely may be necessary. I call this “maintenance supplementation”. Other nutrients that may fall into this category, depending on your diet and health needs, include vitamin A, vitamin K2, selenium, iodine and vitamin C. Vitamin A is only available in significant amounts in organ meats and fish liver oils. While it’s certainly possible (and desirable) to eat organ meats, many people have a strong aversion to them. That makes cod liver oil — a food-based supplement — the next best choice.

As a clinician that specializes in treating people with complex conditions that haven’t been able to find help anywhere else, and as someone that suffered from such a condition myself, I’m also acutely aware of the value of therapeutic supplementation. Therapeutic supplementation involves taking specific nutrients for a specific purpose for a specific period of time. I use this approach in my practice every day. Of course proper diet is the foundation of my work with patients, but by the time people come to see me they’ve often tried every special diet known to humankind (including Paleo, Paleo Low FODMAP, GAPS, and purposely not following a restricted diet), and yet they’re still struggling. Diet is always the starting place, but it’s often not enough on its own to resolve long-standing, chronic health problems. In these cases, smart, therapeutic supplementation is often the catalyst that takes people from chronic illness to optimal health.

I also know this from direct, personal experience. I used many different supplements for several years — including micronutrients, botanicals, probiotics, prebiotics and more — to first kill the gut pathogens I picked up while traveling in Southeast Asia and then reduce inflammation, restore gut barrier integrity, re-establish healthy gut microbiota and address other lingering issues on my way back to health. I viewed these supplements as a raft that would help me get from one side of the river (illness) to the other (health). And that’s exactly what happened. Today the only supplements I take fall into the maintenance category: fermented cod liver oil/butter oil (for vitamins A and D), magnesium glycinate and, on occasion, a probiotic/prebiotic blend.

If you need to supplement, does that mean your diet isn’t working?

Another argument I’ve seen pop up is something along the lines of “If you need to supplement, that must mean your diet isn’t working.” Or you’ve somehow failed. Again, if we lived in a perfect world where it was possible to get all of the nutrients we need in sufficient amounts from food, where everyone was willing to eat the foods that contain those nutrients, and where modern influences like soil depletion, environmental and food toxins, chronic stress, etc. didn’t exist, then yes, I might agree with that statement.

The Paleo diet is a means to an end, not an end in itself.Tweet This

But in this world, the one most of us live in, supplementation is not necessarily a sign that your diet isn’t working. It’s a means of making it work better. And it can also be that life raft I mentioned above that helps you adapt to a new diet that you’ll thrive on over the long term. When I first switched to a “real food”, Paleo-type diet several years ago, at first I had trouble digesting the large amounts of meat and fat I was eating. My gut was still damaged from the parasites and other gut pathogens I had and the treatments I had done to get rid of them. Should I have given up and gone back to being a vegetarian? I don’t think so; I had already “been there, done that” and I knew what the results were (not good). I knew that if I could just help my body adapt, I’d be able to benefit from the nutrient-dense meats, fats and other foods I was eating.

In the Paleo Troubleshooting Guide I wrote, I used the analogy of someone hooked on heroin. When that person decides to quit, they’re going to go through serious withdrawal, and they’re going to need a lot of support: physiologically, emotionally, psychologically and otherwise. That’s what rehab programs are for. Does that mean it isn’t a good idea for them to get off heroin? Hardly.

Transitioning to Paleo from a Standard American Diet or a vegetarian/low-fat type of diet is not as extreme as quitting heroin, but the analogy still applies. After years of poor nutrition (either too many food toxins or not enough nutrients, or both) and exposure to other harmful aspects of the modern lifestyle, your body may have some recovery or “rehab” to do before it can take full advantage of the Paleo diet. For example:

  • It doesn’t matter how nutrient-dense your diet is if you have low stomach acid or impaired enzyme production, because you won’t be able to absorb those nutrients efficiently.
  • If your sugar cravings are out-of-control because you can’t metabolize fat properly, you won’t be able to stick with a healthy diet.
  • If your detox mechanisms are compromised from nutrient deficiencies and too many toxins, you won’t feel your best.

None of these issues, if they happen, mean that the Paleo diet isn’t a good choice for you. They just mean you need a little extra help — which will be temporary, in the vast majority of cases. (You may also need to tweak your diet a bit to make it a better fit for your needs, which I cover in the Troubleshooting Guide.)

This, of course, is the reason that Robb Wolf and I created the Paleologix line. The formulas aren’t meant to replace nutrients you can get from a healthy diet, nor are they meant to be taken forever (though some may wish to). They’re specific nutrients (vitamins, minerals, botanicals and foods) for a specific purpose (transitioning to and optimizing Paleo) for specific people (those having trouble transitioning to Paleo, or those who simply want to fast-track their transition) a specific period of time (until you’re adapted to Paleo and your health issues resolve). In the end, the goal of therapeutic supplementation — including the Paleologix formulas — is to get you to the point where you don’t need it anymore.

Dogma is the enemy of good medicine. My philosophy on treatment has always been: whatever works and causes the least amount of harm. Much of the time that will be diet. Sometimes it will be a supplement. And yes, occasionally (gasp!) it will even be a drug. The Paleo diet is a means to an end, not an end in itself. Why not use whatever other means we can to achieve our goal of optimal health? We don’t get extra points for wearing loincloths, not showering or brushing our teeth or refusing to go to the hospital when we get in a bad car accident. Most people would agree that clothes, personal hygiene  and emergency medical care are welcome modern innovations. We don’t forsake them because they’re not Paleo; we use them because they make our lives better. Supplements belong in this category too — provided we use them wisely and against the background of a nutrient-dense, whole foods diet.

Now I’d like to hear from you. How do you feel about supplementation? Have supplements been useful for you at any point in your healing journey?

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Comments Join the Conversation

  1. zee says

    Great article. I noticed you had parasites.. Is the paleo diet alone enough to kill them off, or did you have to use certain supplements? If so, which ones? With Blastocystis, I’ve been using Ferula, Artemesia/Berberine, VSL#3 DS probiotic prescription, Black Walnut Hulls, etc. and can’t get rid of it.

  2. says

    I agree Chris, food should always come first!

    But the modern environment and its effect on our bodies is the game changing factor that necessitates the use of nutritional supplements.

    However, where I often see people go wrong is by taking low quality supplements in the wrong dosages and at the wrong times, leading to further imbalances and a worsening of health. Just because something is deemed “natural” and OTC does not mean that it’s totally benign.

    But hey, I’ll take food and supplements over drugs whenever possible!

    • says

      I am also a proponent of food first, supplements second. If someone hasn’t even tried to modify their diet to include things they’re lacking then I won’t recommend a supplement until they have given it a shot. There’s also problems with absorption due to low stomach acid (mainly from prescription acid reducers). Especially calcium carbonate absorption.

  3. Rachel, Minneapolis says

    I tend to think of certain foods as my supplements. Currently at maintenance I do almost daily: cod liver oil, vitamin D3, brazil nuts (selenium), tahini (zinc), sometimes K2, and magnesium and Vitamin C.

    I would like to know which FOODS you take daily as your “supplements.” Or, how one might think that way, like I do with brazil nuts and tahini. This is because I take them regularly and in small quantity, then seem like a supplement to me, rather than a dish of food that I would eat once a week or so. I eat a lot of eggs and don’t really consider them a supplement, but if I were talking to a person without knowledge of nutrient-dense eating styles, I would have to begin to qualify the foundational foods, as well. But, there are some foods that are specific to the nutrients in which we are most depleted, and which are so foundational to health that we need to treat that food like a supplement and remember to eat it often enough to gain the benefits.

    Do you have a list of such foods? Not every “super berry” out there, but the foods that address the big issues like magnesium depletion, or the “biggest” issues? Because there are a lot of busy moms, busy people who need the most bang-for-their-buck in terms of money, time and effort. We need the top 5 or top 10 or something that makes it easier for us. And maybe there’s some food you eat regularly that we haven’t thought of. My family won’t eat liver, and from there we digress.

      • says

        I would love to see a list, too. Currently I am taking acerola cherry powder for a vitamin C boost. I “take” Brazil nuts, too, for selenium and kelp for iodine. I’m adding trace mineral drops that come from the Great Salt Lake to my drinking water for a magnesium boost, but I still take a pill. Just remembered pumpkin seeds are a great source so will try to eat more of those. Oysters could make a good zinc and iron “supplement” (selenium, too). Liver is obviously a good one for a number of things–I take actual liver pills in addition to eating it here and there. One could eat natto as a k-2 supplement, if one actually liked it. Just some ideas.

    • DaVid says

      Try adding a small amount of calf liver to meatloaf. Adding seasoning and things like bacon or cheese help cover the taste also. Start with a small amount and work from there.

      • Tom says

        Calves liver is amazing but hard to find. Whole Foods used to have grass fed calves liver from New Zealand, but I haven’t seen it there for ages. Does anybody know of a reliable source?

  4. Nilofer says

    In the late 90s I became a vegetarian and started taking a multivitamin at the same time. I couldn’t believe how hard my nails became and how infrequently I got colds. I stopped being a vegetarian after about 3 years but kept taking a daily multivitamin. Whenever I stop taking it for any length of time during the Fall or Winter, I will usually get a cold. It is the sort of thing that one has to experience to believe since the medical establishment is so quick to marginalize supplements.

  5. Christina E. says

    Generally speaking, if someone is taking digestive enzymes due to the absence of a gall bladder, can they expect to have to take them indefinitely?

    • jayjay says

      I would also like to know what kind of hinderence to paleo fat digestion do those without a gall bladder have and if we have to adjust our diet or take supplements(indefinitely).

      • Jenni says

        Jayjay–I would love to see a post about your concerns, too! Is it true that coconut oil is fine in any quantity for people who’ve had their gallbladder removed? And what should people who still have their gallbladder but have problems do?

    • Gabriella says

      I would be very interested in your answer Chis also, I’ve been taking bile salt for about a year now, due to no functioning gall bladder. How long should I expect to take it before my gall bladder starts kicking in again? I’ve been following a Paleo diet for about 2 years.
      Thanks

  6. says

    I think supplements are necessary and helpful. It’s important, though, to pay attention to additives and fillers. Some dietary supplements contain harmful substances or ingredients that you may be sensitive or allergic to.

    “Dogma is the enemy of good medicine”. So true!

    (Btw, the first “tweet this” isn’t working)

  7. KateInHawaii says

    There is good info here, along with selling something. I will tell you that us consumers out here are getting BOMBARDED by these specialized product sales to the point of tossing out the emails before being read. How do we keep info and sales separate?

  8. says

    Love this post, thank you! I am not taking any supplements right now. I’ve been Paleo almost 2 years, and continue to get more and more into it, and understanding different things. I’m about ready to embark on a strick AIP (I also have type 1 diabetes [for only 6 years], which I think my 16 years of poor digestion and leaky gut eventually led me to), to see if it helps heal my gut! And I’m reading now about supplements that can assist, because I’ve been suffering for so long, I truly feel they’re needed to help get me over that hump. This has been a journey for me, and I am confident that I can heal my gut, as years of modern medicine combined with diagnostic testing-has done nothing (wish I knew then what I know now, obviously, but better late than never). I’m doing the absolute best that I can, to reach optimal health, if (proper) supplements help me get there, then I’m totally willing.

  9. Patty says

    Fermented Cod Liver Oil Question: If one takes a quality bioavailable mutlivitamin such as your new line, or those specifically made for SCD (similar to PALEO but tweaked for autoimmune IBD… so micronutrient absorption is a key concern… that’s why the “insurance policy” of a multivitamin) would it not be toxic and ill advised to ALSO take FCLO since vitamins A and D are cummulative fat soluble micronutrients? Help… you did not address this in your article, which I did find informative and wonderful!

  10. says

    Since I recognised that I have reaction to the substances in a multivitamin I have not taken a single pill of anything, which before was 2-5 pills per day as a minimum. That was over 18 months ago and by today I did not experience any negative side effects of not supplementing, actually I only have seen improvements in my health. Supplement by real foods.

      • gregory says

        I have terrible stomach pains also, with just about any supplement. I’ve undergone many, many tests and the only thing that came back positive is steatorrhea. Have you found anything that helps you with chronic stomach pain???

  11. Wes says

    Chris, appreciate the post and love your blog.

    However, this post conflicts directly with the book you recommend a lot: The Perfect Health Diet. The Jaminets recommend a list of about a dozen supplements that should be beneficial to everyone.

    http://perfecthealthdiet.com/recommended-supplements/

    Do you not agree on their thoughts on K2, Iodine, C, B vitamins, Biotin, Zinc, Chromium, Vandium, Molybdenum, Boron (and a bunch of other optional recommendations).

    I’d like to know because I’ve been dropping about $150 a month on these for my wife and I since I finished the book

    Thanks,
    Wes

    • David says

      Wes,
      When Chris said he recommended The Perfect Health Diet book, he meant that he recommended it in general, he did not mean to say he agreed 100% with every detail. Supplements are an area that Jaminet and Kresser do not agree on.

  12. says

    I am a person who takes supplements; fish oil (or cod liver oil), vitamin D3, magnesium and a multivitamin to name a few. I took statin drugs for years and was damaged badly by them so I never forget to take Ubiquinol every day. The statin drugs left me with very bad neuropathy so I also take rAlpha Lipoic Acid and Evening Primrose Oil.

    I’m also diabetic and take metformin but it has terrible digestion side effects, and I have had my gall bladder removed, so I also take probotic enzymes to help with that.

    That sounds like too many supplements, but that’s what’s working for me. The rAlpha Lipoic Acid has helped me extremely with the peripheral neuropathy…I can walk again, and those shooting pains in my feet are gone.

    I would like to see a list of the top 5 or 10 supplements you suggest.

    Thanks for great information all of the time!

  13. Gary Ogden says

    Chris:
    Heard you in Santa Clara, and was fascinated. Wish it would appear as an article in Wise Traditions, as some do. I would also recommend Co-Enzyme Q10 for us older folks (I’m 64, and in excellent health), and high quality cod liver oil/high vitamin butter oil for nearly everyone (Green Pastures is the only high quality one I know of). I also take a high quality multi-vitamin/mineral for “insurance.” Magnesium is so crucial and so deficient in most people’s diet (potassium, too). I get it from small amounts of crispy pumpkin seeds (richest food source), daily bone broths, a small amount of Azomite daily, and a spray-on magnesium chloride. I try to eat large amounts of a wide variety of leafy greens daily for potassium and numerous other goodies, and plenty of animal fat. Thank you for what you do!
    Gary

  14. Dee says

    i loved the article too. I just want to give praise to you for being a little critical to paleo diet. I think it’s a fad, just like atkins. These cavemen died at age 40. Antibiotics can save lives, dairy is not that bad and beneficial for kids. My husband’s grandmother was amazingly healthy and chipper until 104 and she would advice shot of whisky at night sometimes:). Researchers point out that positive attitude is number one for health and we should look around and see that negative people are not healthy.
    I take supplements and they help me tremendously. I had a huge intestinal issues after pregnancy. I know if I would go to doctor, they would give me some horrible drug. Instead I experimented on myself. It took me long time, but finally found excellent product–Kyolic Candida cleanse. I believe anybody with intestinal problems should try it. The problem with grains is that manufacturers are adding gluten to the products. If we grind our own flour, bread can be a good source of nourishment. Mr. Kresser’s suggestions of taking approach to food and supplements holistically is excellent. we are removed from nature. We should be outraged that schools keep children sitting for long periods of time, workplaces reward staring at the screen, then we punish ourselves coming home eating dinner and watching tv! we live in unhealthy society and it take conscious effort to be just somewhat healthy! I’d say let’s advocate for yoga breaks for adults, phys ed, fun games every day in school–let’s start there. SOrry to ramble. excellent article–engaging:)

    • Chris Kresser says

      Dee: I was not being critical of the Paleo diet in this article. I think it’s a fantastic dietary approach, especially when personalized to fit the individual. My point was simply that diet alone — regardless of how nutrient-dense it is — is not always enough to solve every health problems.

    • says

      Dee,
      I’m sorry, but I have to comment on the life expectancy of those living in the Paleolithic. It’s an average, not a maximum life span. They didn’t all just drop dead on their 40th birthday (wouldn’t that suck!). While the average person alive at that time may have died sometime around age 40, many lived into their 70s, 80s, and 90s; many never lived past childhood.

      Let’s not forget that infant and child mortality at that time has been estimated to be anywhere between 30-40 percent (http://paleodietlifestyle.com/why-cavemen-didnt-die-young/). It is this large infant mortality that creates these low average life spans. Today’s abnormally low infant mortality (less than 1%) is why we have such a high average lifespan. It’s also why our population exploded in the 20th century (less people dying so young). Most people, if protected from infectious diseases, murder, famine, and a poisonous modern diet will likely live into their 70s, 80s, and 90s before dying of natural causes (as opposed to the degenerative diseases we currently die from).

      And if I was to call any diet a fad, it would be modern ones like the current standard American diet. We all evolved eating a diet filled with fresh whole foods (and no pseudo-foods), so I find it hard to consider all Paleo diets faddish (however, I do believe that low-fat or low-carb Paleo diets are a fad that is currently dying).

  15. jami says

    I was not a supplement user until I found a whole food supplement that is outstanding in quality. My family and I eat a nutrient dense diet 90% of the time and take supplements for maintenance and we all feel great and never get sick. But as others have said here you need to be careful of what’s out there, even in health food stores, if it’s not whole foods then it is isolated laboratory made ingredients!

  16. Stan says

    In 2004 I started reading and taking care of my food, first vegeterian and vegan, and then Paleo and more to PHD. I have not had a headache since then, not to mention cold or flu. I do not use supplement although I tried some several times like multivit, kelp and magnesium. But somehow the kelp pills and multivit are causing an upset stomach. So I am hesitant about starting again. I plan to use magnesium soon. Of course eggs, liver, other organs, cod liver, sprats are regular in my diet.
    But all this info about the diffirent necessary mineral and vits is confusing – which are the really necessary ones for otherwise generally healthy person.

  17. Tom Dolan says

    Seems like I’ve always used supplements of one kind or another. But since moving away from my orthomolecular physician in 1979, I have no idea how much HCL, digestive enzymes, pro-biotics, raw glandulars, etc. to take. Trial and error is expensive. I have a closetful of supplements that have not helped or have made me feel bad. Does anybody out there know of a doc in Honolulu or anywhere on Oahu who would test me? Or anybody who could do a consult via e-mail and concomitant blood testing? Playing by ear and listening to my body has worked to a certain extent, but I have the nagging feeling I’m taking too much of this or too little of that. Any advice would be appreciated.

  18. Natalie says

    Chris,
    I have not had good results with taking any supplements. This past November my GP told me to start taking calcium and vit. D and a few weeks later my ankle was swollen. I thought I tore something in yoga class , but an MRI showed nothing. Having Crohns for 20+ yrs., I never had joint issues, but now it’s a constant battle. I have stopped all supplements for now, and hope to regain my health back with whole foods.

    • irexx2 says

      Natalie, see urban domestic diva ‘s blog about her firsthand account on the ‘significant’ positive impact Anatabloc has had on her Crohns / IBS condition. As I’m sure you’re aware Crohns is inflammation driven and down regulating or removing that inflammation is the treatment method. The problem has been that most drugs do as much harm, if not more, than good. NSAIDs, Corticosteroids, Statins, can be very harmful long term.
      Antabine citrate has the ability to safely (zero side effects, zero drug interaction) down regulate chronic systemic inflammation in the body. Consider man has been ingesting the foods that contain anatabine citrate for thousands of years, just not enough of it often enough to reap the therapeutic benefits. Wiki anatabine citrate. Chronic inflammation is the root of 98% of the disease humans are afflicted with so it’s becoming the #1 subject of discussion regarding health and aging.

      • says

        I’d be interested to hear about anyone taking Anatabloc for Chrohn’s.I bought some for my brother who has it. My doctor is a big believer in Anatabloc, takes it himself, and has recommended it to some of his patients.

  19. Emily says

    Chris I was just wondering if you recommend an iodine supplement such as iodoral during pregnancy for people without thyroid issues? It’s not referred to in your healthy baby code but I’ve heard of adverse consequences of iodine deficiency during pregnancy. Is it safe to take such a dose as 12.5mg per day or is this excessive?

  20. Jill says

    Chris,

    My husband and I have an 18 month old daughter who eats mostly paleo/primal, and I was wondering if you recommend she take cod oil and vit D supplements in addition to her diet? She is not a big fish eater, so I am concerned that she should be taking a cod oil or fish oil supplement to balance out her diet. Do you give your daughter any supplements and if so do you recommend certain brands? Thanks!

    • Denise says

      My 3 year old daughter is also mostly paleo/primal and not a huge fish eater. One evening (about a year ago) my husband and I grilled salmon for ourselves, and she tried some. We were so shocked when she couldn’t shovel it in fast enough! Now we try to make this once a week. I think the strong flavor is what appeals to her.

      We prepared it as: skin-on filet of salmon; dry rub mix of salt, pepper, cumin seed; lightly coated cast-iron two-burner grill pan with coconut oil, preheated to just smoking; lay salmon, skin-side down, on pan, cook for 4-6 minutes; place pan under pre-heated broiler (on high) for another 4-6 minutes. Fabulous fish flies fast off fork!

      Good luck!

      • Jenni says

        I second this–my 3 year old adores grilled “pink fish” and easily eats an adult-sized serving every time. We just brush on butter with dill.

  21. says

    Not just any supplements though. You want the best quality of supplements, for the best quality of life. Ideally, pharmaceutical science applied to nutraceuticals with quality process control.

  22. Carly says

    Chris – I greatly appreciate this post and like your “paleo diet as a means to an end, not an end itself” approach and using whatever means to achieve our optimal health. I take supplements under the guidance of a nutrition consultant who utilizes hair analysis for nutritional status and is a proponent of the paleo framework. My hair analysis results indicated adrenal fatigue evidenced by a very strong Na+/K+ inversion. A paleo diet wasn’t enough to overcome the inversion and the addition of the right concoction of supplements has been producing fascinating results in my recovery process (i.e. no longer caffeine dependent and exercise addicted). Supplements definitely have a place, they can be very powerful, and it is so extremely important to use them wisely. Thanks for the informative post!

  23. Dana says

    My philosophy about supplementation vs. dietary style is that if your prescribed diet *does not allow you* to obtain a certain nutrient because that nutrient only exists in foods you’re not allowed to have, *that* indicates you’re following a bad dietary style. But Paleo could in no way fall into that category. You are allowed such a huge variety of food, and you are allowed *all* the animal foods except dairy (unless you’re Primal, and then it depends), but you can get the nutrients we most look for in dairy by consuming organs and bone broth, so that’s not as bad as it sounds to some.

    There’s a difference between “I need to supplement with vitamin A or fish liver oil because I hate liver,” and “I need to supplement with vitamin A or fish liver oil because I’m a crappy beta carotene converter and I’m *not allowed* to eat liver.”

    I think that’s where people get a little bit confused.

  24. Thy Fere says

    Hi Chris,

    You didn’t talk about Omega-3, is it necessary? Most of the people have no access to grass fed meat and pasture eggs. What should they do?

  25. Mark says

    Hi Chris,

    Great blog(s). Above you say that our modern environment is profoundly different than that of our ancestors and one example you give is:

    “A decrease in diversity of plant species consumed.”

    With being able to get a wide range of fruits and vegetables from different continents not increase the diversity of the plant species we consume? Just a thought…

    Keep up the great work.

    Mark

    • Sara says

      I was thinking the same thing! I live in Seattle… I have easy access to grass fed meats, eggs, liver, butter, etc. + seafood + endless varieties of organic fruits & vegetables + coconut oil + exotic spices, etc. Many of these come from different parts of the country / world.

      I have to believe in “paleo” times my food options would have been limited… especially in the winter (when you consider what grows naturally here). I’d miss out on a lot of antioxidants (berries, colorful veggies, etc) & healthy fats (example: coconut oil). These are NOW available but would not have been back in the day. It seems that my need for supplementation would be REDUCED versus INCREASED based on the food items currently available. Or am I missing something? Possibly the soil is not as nutrient-rich but I’d think that would be more than countered by the increase in variety & abundance.

    • Jasmine says

      Hi Chris
      When I read that, I also questioned it; in today’s society we seem to have access to the food of every country!

      Then I realised Chris Kresser was probably referring to the fact that farmers specifically breed only certain types of fruits and vegetables. They choose the ones that are easiest and quickest to grow, the ones most resilient to climate and pests, and the ones that taste better because consumers are more likely to buy apples that taste sweet as opposed to apples that taste ew.

      Because of that, the majority of plant species available to us at grocery stores are actually only a small select few that exist in nature.

      I’m just guessing so I hope I’m not giving anyone misleading information :)

  26. Juliebgood says

    Since childhood, I’ve had Keratosis Pilaris – that annoying goosebumpy “chicken skin” on the backs of my arms (and in adulthood, the backs of my thighs as well). Very annoying! So I’ll share a supplement that’s done wonders for me – liquid cod liver oil, specifically, the vitamin A in it. Literally within a week of starting it, my KP was 90% gone. If I go off it, though, it comes back within a week. Eating beef and chicken liver weekly does not give me anywhere near the results that cod liver oil does; I don’t notice any result at all, actually, just eating liver.

    So yes, supplements can be enormously helpful!

  27. Jasmine says

    I was the healthiest when I was seeing a naturopath and taking the supplements she prescribed.
    That’s mainly because my diet is awful so my body thrived when I was swallowing pill nutrients.

  28. Simon says

    Hi Chris
    I live in the UK and am very interested in studying functional medicine. I am a qualified nurse and am currently training as a paramedic. Do you have any ideas where I should start looking?
    Regards
    Simon

  29. Bet says

    As with diet, taking supplements will be individual. Yes, you can and should get nutrients from foods, but as Chris said, many of us don’t have the ability to digest and absorb important nutrients in foods because of years of damage to our gut. For instance, someone upthread mentioned Brazil nuts. I love nuts, especially Brazil nuts, but right now I am not eating them because they can be an irritant. I am also not eating a lot of vegetables for the same reason. So for me supplements are the way to go. I am taking HCL, Krill Oil, B12 sublingualy, and I recently added Siberian Ginseng and B5 for cortisol issues. Maybe I won’t always have to take these supplements, but I am not going to suffer poor nutrition because I become too dogmatic about getting everything through my diet alone.

    • says

      I don’t consider Siberian ginseng to be a supplement. Chinese medicine school of tonic herbalism has used it and other adaptogens for thousands of years. I would classify them as superfoods to enhance health and promote longevity. See Adaptogens: Herbs for Strength, Stamina, and Stress Relief and The Ancient Wisdom of the Chinese Tonic Herbs.

      Adding tonic herbs to a Paleo regime, appropriately selected for a person’s individual constitution according to TCM principles, can greatly improve a person’s health.

  30. irexx2 says

    Great article.
    `Dogma is the enemy of good medicine. My philosophy on treatment has always been: whatever works and causes the least amount of harm.’
    I totally agree. Regarding therapeutic supplementation; I have been taking Anatabloc since it’s release to the public in 2011 to help with arthritis pains that developed over time. At 55 I am fit 6’2″ 185 but suffered years of debilitating low back pain episodes, chronic hip pain diagnosed as arthritis, and frozen shoulder more than once. After about 3 months on Anatabloc these aches and pains diminished and in most cases disappeared altogether. Today I have none of those symptoms. Anatabloc has removed the chronic low grade inflammation in my body. It works at the cellular signaling level by blocking NFKB activation.
    Have you heard of this nutraceutical? It contains a synthesized version of anatabine citrate which is found naturally occurring in tomatoes, potatoes, eggplant, peppers, and even in tobacco leaf. I would really like to get your take on this supplement and it’s ability to down regulate the inflammation process in our bodies.

      • irexx2 says

        Matt,
        I agree with you completely and prefer natural compounds over manufactured from the ground up chemical concoctions produced and pushed by big pharma. The ‘natural’ label is bit more complex than at first glance however.
        Nutraceuticals are foods or food-derived products that are meant to provide health benefits. They may function exactly like substances that are FDA-approved pharmaceuticals, but they are not categorized as such.
        For example, you may take or sell the extract of willow bark for use as an anti-inflammatory, anti-clotting agent or pain killer without getting FDA approval. You can’t make medical claims about willow bark extract, or the active ingredient salicylic acid, however. Current government policy in the US and many other countries is to reserve that right for products that have passed extremely lengthy and expensive approval procedures.
        If you synthesize a very similar compound, acetylsalicylic acid or aspirin, you have a drug. With regulatory approval, you can therefore make certain kinds of claims regarding its efficacy in the prevention of heart attacks or strokes. There is very little difference in the actual function of the two products, though.

  31. Tom Dolan says

    Trial and error is not the best way to choose supplements, yet that’s what many of us have to do, filling our cabinets with products that were costly and unhelpful. Supplements are probably the last thing on my GP’s mind when he sees me once a year. He’s thorough but poorly trained in nutrition and alternative or natural medicine. If it weren’t for blogs like this and other internet resources, I’d be completely on my own. Honolulu desperately needs a good orthomolecular physician.

    • Rachel, Minneapolis says

      A friend of mine has been struggling to learn and use orthomolecular, natural, nutritional approaches to her health problems. One thing she did is get a 23 andMe genetic test. There are some doctors out there trying to interpret the results of the test for people. For the layperson it is quite complicated and we could use more physicians who have the background to understand it. But finding these people is a problem also. It seems people do better in groups where there are knowledgeable individuals who converse with a group and teach them. Find others like themselves, same problems. Maybe a co-op style of health care, solving many of the same problem at once, group consultation style.

      Chris, perhaps you could cover nutritional testing of various sorts. I’ve heard hair testing is good. I’ve had a blood panel for nutrient statuses called Spectracell.

  32. says

    I like ground coral, bone meal, Mincol and a wide variety of organic wild seaweeds. Since a Paleo diet does not include dairy, a huge amount of calcium is taken out from the diet. By no means do I imply that dairy is essential However, today’s vegetables, meats, etc. have nowhere near the calcium content the used have and need to have to promote optimal health. This is because of depleted soil, whether you eat organic, grass fed or not. To get a crude idea of how much calcium levels have plummeted over the last 80 years or so see http://www.mineralresourcesint.co.uk/pdf/mineral_deplet.pdf. Coral calcium, a bioavailable form of calcium packed with trace minerals, consists of the dominant calcium compound calcium carbonate. It helps to make up for the lack of calcium in foods that have this dominant calcium compound.

    Someone may say wouldn’t bone meal be enough since it is a very good source of calcium? The answer is no because bone meal has the dominant calcium compound of calcium phosphate. Different foods have different calcium compounds and we need all 5 different compounds for optimal health. Not all calcium is the same – they have different effects on body chemistry. Different people have deficiencies of different calcium compounds.

    Bone meal contains electrochemical compound colloids, something also lacking in today’s foods just like the calcium. A much better source, however, is Mincol. Daily manufacturing makes it and you can make your own at home. The Hunzas had this natural occurring in the glacier water. For more information, see http://highbrixnutrientdensefoods.com/2012/10/09/the-benefits-of-high-brix-nutrient-dense-foods-part-3-electrochemical-compound-colloid/ and http://highbrixnutrientdensefoods.com/2012/11/02/more-on-electrochemical-compound-colloid-post-2/.

    Kelp has the dominant calcium compound calcium oxide and tons of trace minerals, something lacking in our real foods supply even more than calcium.

  33. Lori says

    The only MK-4 capsule supplement I can find has 15 mg per capsule. Is it okay to take that amount? Because I much prefer capsules. The only other option I can find is liquid drops, which (I think) contains ~1 mg / drop. There must be some purpose behind the much greater amount, so if you’re aware of what that might be, I’d be interested in hearing about that, if it’s not too complicated to explain.

  34. Mike says

    Regarding supplements; above poster ires mentions anatabloc. Folks this is the first supplement I have ever taken that has a material effect in the way I feel. I have supplemented for decades with multi’s then more specialized supplementation through the years hoping there would be an eventual payoff like staying out of the doctors office and living longer. But never felt any better or worse or least not readily detectable. Anatabloc has changed all that and one thing that has been measured by my GP is my CRP level which went from 3.86mg/dL to 0.68mg/dL in a span of 6mo.
    See user reviews at GNC for anataloc. Incredible but just the tip of the iceberg.

  35. George says

    Hi Chris,
    My wife has allergies against fish, nuts and raw eggs. This comrprises all seafood, all nuts (not peanuts as they are legumes, not chestnuts or pine nuts). She had this allergies all her life (60 this year) and is now getting increasingly concerned about the need for supplements, in particular as there is a history of dementia in her family. In our view, we are on a healthy diet, with plenty of veg (much from our allotment), dairy products and some meat.

    I would very much appreciate your advice

    Many thanks

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