Thursday, 9 November 2017

Supplements: Gimmick Or Good For You? - by Lauren MacDonald

This week's blog is another from Lauren MacDonald, a 29 year old junior doctor when she was diagnosed with stage IV cancer, who is now celebrating one year NED. Here she discusses her thoughts on supplements...

I was incredibly anxious when I was first diagnosed with cancer and was keen to exert some control back over the crazy world I’d found myself in. One of the first things I did involved going shopping for supplements. I figured that if there was anything I could buy over-the-counter to support my health, it was my duty to buy it. At one point I was taking over 25 different supplements everyday. That may sound excessive, but apparently increasing amounts of us are taking vitamin pills and herbal supplements with the aim of protecting ourselves against all manner of health problems. In the UK the market is currently worth £650m, with approximately 40% of us now popping a pill or two each day. The industry is phenomenally powerful, extremely lucrative and incredibly influential. But should we be taking all these supplements?

Gimmick or Good For You?

The supplement industry is divided into three groups: (1) vitamins; (2) minerals such as zinc, copper, selenium and iron; and (3) dietary supplements such as fish oils, herbs and spices. I went out and invested in various tablets and powders from across these different groups. This was despite my medical knowledge regarding how supplements are likely used by the body. From what I’ve been taught it seems that our bodies are not particularly efficient at digesting, processing, and absorbing supplements in pill form. When you take a pill it first travels to the stomach, where it breaks apart and releases the nutrients it contains. These are then absorbed and processed (usually by the liver), from where only a fraction of the nutrients then go on to enter into the bloodstream. Consequently it’s likely that plenty of supplements actually end up in your urine.
Another issue is that even if your body can absorb some of the nutrients, there is often limited scientific evidence available to support the use of many supplements. Having said that, this is often due to an absence of any proper scientific testing. In this situation all anyone can do is speculate about whether there are any benefits to be gained. Because of this, at the time of my diagnosis I was more than happy to buy my supplements under the caveat that “the scientific proof possibly just hasn’t been confirmed yet”. In my eyes being a guinea pig was far better than sitting back and doing nothing. Plus several friends offered up stories about their distant relatives/friends/neighbours who had cured their cancer by taking a concoction of supplements.

My Experience With Supplements

On reflection I’m sure that as a GP I wouldn’t have been overly enthusiastic about any of my patients taking 25 random pills every day. But back then, my rational “doctor voice” was drowned out by my petrified “patient voice”. I eventually got to a point where I couldn’t walk past a health food shop without diving in to buy the latest “cancer killing” or “immune boosting” supplement. My cupboards were full of spirulina powders to add to my juices, and chaga mushroom granules, dried cleavers, and pau d’arco to make up as teas. The supplements I was taking ranged from standard multivitamins and fish oils, to more unusual supplements like milk thistle, astragalus, and sea kelp. I was probably taking them regularly for about 6 months; right up until until the cancer came back.
Around the time I progressed to having stage 4 cancer (meaning that the cancer had spread to my chest from my leg), some new evidence was published which scared the bejesus out of me. Two studies had found evidence that taking supplements may actually increase the spread and severity of some cancers (specifically melanoma and lung cancer). Overnight my 20 supplements didn’t seem so “life saving”. Obviously this research was only preliminary, but it was enough to make me consider that maybe I shouldn’t be taking quite so many supplements, especially without having mentioned them to my oncologist.
If I’m truly honest, I’m really unsure. From the research I’ve read it would seem that the answer is no. The problem is that it’s almost too easy to get your hands on supplements. These days there is a pill available for absolutely anything. Whether you have trouble sleeping, want to lose weight or get more of a certain vitamin into your body, there is a wide range of aids to choose from. Recently several studies have taken place to attempt to justify the use of vitamin and mineral supplements but the majority of them have come to the same conclusion – there is no concrete evidence to suggest that dietary and nutritional supplements have any real positive impact on health. Scientifically speaking there are no miraculous supplements that will help you find solutions to multifaceted health problems – especially not cancer. But it’s easy to fall for marketing promises and personal success stories.
Luckily it’s pretty easy to get everything you need just by eating a balanced, healthy diet and going outside every once in a while. Other than perhaps vitamin D, you don’t actually need to load up on extra amounts of these compounds. And in some cases you can actually overdose. For example, excess vitamin A in the body can cause blurred vision, dizziness and bone softening. However, there are some instances when certain supplements become necessary. For example, very strict vegetarians may need supplementary vitamin B12, and those who are pregnant or breastfeeding should consider vitamin D and folic acid.

My New List:

Two years ago, along with adding in a huge amount of supplements, I also gave my diet an overhaul. Although I have relaxed a little, I still eat a largely plant based diet and it is mainly through food that I now nourish my body – not supplements. My diet now includes more specific food items, such as, nuts and seeds, pomegranates, shiitake mushrooms, fermented foods, fresh turmeric, bee pollen, watercress, parsley, green tea and a whole host of other random bits and bobs which potentially have “immune boosting” or “cancer fighting” properties. Although I haven’t completely stopped all supplements, I am weary of taking too many. I am having regular infusions of Pembrolizumab (immunotherapy) and the last thing I want to do is cause any interactions, or prevent my wonder drug from doing it’s thing.
So…. what made my list?
(1) Vitamin D
Vitamin D helps to control the amount of calcium and phosphate in our bodies. Both are needed for healthy bones, teeth and muscles. Very few foods contain vitamin D (and those that do, such as milk and orange juice, are fortified). We tend to get most of our vitamin D from sun exposure, but in winter this can be problematic.
(2) Omega-3
Omega 3 helps protect against diabetes, heart disease and stroke, as well as providing support for brain health and memory. Found in oily fish such as salmon and tuna, many of us are deficient in omega 3 as we just don’t eat enough in our diet.
(3) Probiotics
I have an entire blog post dedicated to my love of probiotics and gut health in general. I cannot rave about them enough! Take a look at the post here.
(4) B Vitamins
B12 is an essential nutrient needed for nearly every bodily function and energy production. Low levels can cause damage to the nervous system and some of the early signs of deficiency are chronic fatigue, moodiness, and even dementia-like traits. Because the body cannot produce it on its own and it’s also scarce in our food system, it is advised for those with low levels to take a B12 supplement.
And that’s it.
From 25 supplements down to 4. It may seem simple but there it is. If you are taking care of yourself and eating a healthy balanced diet then if you ask me, these are the only supplements you should consider. Having said that, although I’m a qualified doctor, I’ll be the first one to put my hands up and admit we didn’t learn a huge deal about nutrition during our medical degree. To be honest I feel like I’ve taught myself a great deal more about nutrition and supplements since I was diagnosed with cancer. Because of this, I’d just like to highlight that the above information is my opinion only, and does not necessarily represent that of the wider medical community. I’d love to hear from any registered nutritionists or dieticians if you feel that I’m way off the mark with my opinion on supplements. I’m open to learning new things!
Lauren x
Please remember that it’s always advisable to seek professional advice before taking supplements anyway. Speak to your GP before you introduce anything new, especially if you take regular medication.

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