Comment by munchhausen | Hacker News Reader

Comment by munchhausen | Hacker News Reader

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Thank you for posting this article. It gave me pause for thought.

I have been taking a green tea supplement occasionally. I saw it in a vitamin store, and bought it because of the supposed benefits of antioxidants. I figured - I have a stressful job, I live in a polluted city and do drink alcohol - I probably need the antioxidants. Plus, something that's made out of green tea sounds safe, not likely do any harm, right?

Well. I am disposing of the supplement, obviously. More to the point, though, I have to revisit my whole thinking process around supplements. I take a bunch of them, and it's purely on the basis of "I read a study somewhere or other that this is supposed to be good for you" - and not because I have a specific health concern that I need to address.

This approach suddenly does not seem so sane anymore, and I need to take a step back and rethink what I am doing here.

It's amazing how easy it is to gradually lose touch with your common sense, simply because you read the "right" subreddits (in this particular case, /r/nootropics), and start to subscribe to the hype.

The general rule is: You don't need supplements. Period.

That's because supplements provide (or are supposed to provide) trace elements that you need, but you only need a little bit of it. Like minerals and certain vitamins etc. The thing is - you basically need the same (trace) amount of it, whatever your lifestyle is. And you get it through eating a normal varied diet (e.g. a little meat, vegetables, some fish and seafood when you can, some (unprocessed) grains). So when do you not get enough of it? When you don't eat much food, or not enough of certain kinds of foods. Say, if you are a vegan with a sedentary life style. You're simply not getting enough of the trace elements through the restricted type of food you eat. If you're an athlete and you're also a vegetarian then you don't actually need food supplements at all - you're eating a lot of food due to the energy requirements and you'll get enough of it. Think Roman gladiator - they were vegetarians. No supplements needed.

For some reason a lot of people think that you need supplements if you excercise a lot, while it's in reality the other way around.

No, the general rule is: Talk to your doctor if you're wondering if you should be taking supplements.

Your generalization potentially puts people in harms way.

A varied diet is not always enough - some vitamins and minerals affect how others are absorbed and whether or not they are available to your body. And heavy exercise can cause deficiencies if your diet doesn't contain enough of the substances that you lose while sweating, even if you do eat enough to maintain your weight and muscle mass.

I've experienced this personally. There was a time in my life where I was exercising significantly more than the average person, although obviously not as much as a professional athlete. Even though I ate enough to maintain my weight, and had a fairly varied diet, I still ended up with an iron deficiency that was almost dangerously low, and this was only caught when I had some blood tests done to help rule out causes for my sleep issues.

Most supplements aren't needed, but vitamins and minerals such as B12, D, calcium, and iron (and others, although most of those are less frequent and can take much less time to build up the necessary quantities in the body) can end up at problematic levels even when you think you're doing everything right.

Right, I know someone who has a severe potassium deficiency and through multiple methods (including but not limited to increased milk & banana consumption and a large potassium pill) gets to where blood tests return "low" rather than "dangerously low"

Oh yes, if only people ate a perfectly balanced diet and had time and resources to know how to get the exact quantity of every ingredient.

Saying "you don't need supplements" is naive idealism.

And here's the catch, "healthy people don't need supplements" but how many people are taking multivitamins and hence supplementing a dietary deficiency?

"Don't take vitamin D" until you have an issue and then have to go to the doctor?

> Think Roman gladiator - they were vegetarians. No supplements needed.

Suuuuure. Did you do a blood test on them? I'm not so sure the lion's diet was balanced in the end though.

Yes, do not take vitamin D unless under the direction of a doctor. As a fat-soluble vitamin, it's not super difficult to poison yourself with it.

Max recommended dosage for adults: 100ug per day (4kUI) with some places suggesting 250ug https://en.wikipedia.org/wiki/Hypervitaminosis_D#Suggested_t...

Typical supplement dosages: from 5ug to 25ug

So no, unless you eat Vit D supplement like candy you won't have a problem

Without knowing your deficiency, you're either taking a comically meaningless dose (why even bother to take a 5ug dose if you're at a 250ug deficiency?) or risking overdose by swamping your system with the 250ug over the counter pills while not actually being deficient.

This isn't the case.

Your fear of overdose is misfounded. You have to try really hard. Deficiency, on the other hand, is endemic.

"Vitamin D deficiency is a major public health problem worldwide in all age groups, even in those residing in countries with low latitude, where it was generally assumed that UV radiation was adequate enough to prevent this deficiency, and in industrialized countries, where vitamin D fortification has been implemented now for years."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4018438/

The problem is: Doctors will only test for _suspected_ deficiencies. I'd love to know my vitamin levels, but I don't believe my doctor would be as enthusiastic about multiple blood tests to satisfy my curiosity.

Lol. Guess this means I live life on the edge.

There are tons of edge cases where taking some supplements are much better than not taking them. Your argument about some gladiator is a laughable one - who knows what they ate 2000 years ago, what their actual health was? They needed to fight and often die, nobody cared if they have a healthy retirement.

I personally take multivitamin supplements, but the key to me is moderation - half a tablet on workout day, which has all the vitamins in 50% daily dose, and range of minerals of 15% daily dose, drank with lunch. No crazy doses of something specific. It helps with regeneration of muscles, joints and whatnot. Actually, my teeth got measurably harder according to my dentist after I started this regime.

The thing is, I work out these days 5x pretty hard during work week (weights, various running/cardio/intervals), mostly 1x climbing session on the evening, and 1-2 multihour hikes with 5-15kg backpack over weekend (or something similar). Those advices of daily dosages are for people smaller than me (188cm, 93kg), doing fraction of exercises compared to me. Could I do all of this without any supplement? Of course. But so far I haven't heard any solid reason why, because it measurably helps in many aspects of my health and wellbeing.

> 'who knows that they ate 2000 years ago, what their actual health was?'

That's not so difficult as you think. What you eat is preserved in your teeth and bone. See https://www.atlasobscura.com/articles/what-did-gladiators-ea... As for what their health was - again, you can find out a lot from bones. And, as you said, they needed to fight. You don't do that for very long without a certain level of health.

When you describe your exercise regime you seem to assume that more exercise == higher doses (of trace elements) needed. But that's the thing: For nearly all of the common trace elements, it doesn't change. Of course it varies with weight - there's a difference between a 45kg small woman and a 100kg man. Probably. But your size and weight is well inside the general and means very little in this respect.

If I am 15-20% heavier than average human, then getting extra 15% of minerals with supplements sounds like a good idea to actually meet daily requirements. You make claims that we are all OK and shouldn't take anything, but you have no clue what I eat, how much, or what are specifics of my body - that's not very scientific statement. I still haven't seen anything scientific stating that 15% extra intake in most common minerals should bring anything but benefits.

What minerals can be used for - Mg for preventing muscle cramps (scientifically and practically proven), Fe for altitude acclimatization (more red blood cells to transport oxygen), Ca for teeth and bones. Its proven that weightlifting makes your bones denser/thicker, so I supply my body with a bit of extra of material.

As for Vitamins, water-soluble will be washed away (and its always good to have a bit extra of vitamin C), and the fat-soluble are actually less than recommended doses last time I checked (particularly Vitamin D, and as said I take 1/2 of it).

What I consider important is to take it with big meal which contains tons of stuff - especially fats and some fiber. That way body has a more gradual intake of these, and stays in stomach/intestines for longer.

What are the measurements, then?

How do we know that none of this is placebo.

Long-time swimmer here. Without extra magnesium, I will get spasms in my legs from time to time while exercising. With extra magnesium, I don't.

I used to be a competition bicyclist - daily training sessions of hours and hours. If you don't get enough magnesium, look at your diet. With normal healthy food you should get more than enough.

>With normal healthy food you should get more than enough.

No, I looked into it some years ago and it seems unfeasible. For instance you'd have to eat about 15 stalks/heads of broccoli daily to get the RDA of magnesium, and that amount is likely suboptimal.

I had a look at https://ods.od.nih.gov/factsheets/Magnesium-HealthProfession..., and I can definitely say that with the amount of food I was eating during my bicycling years I would have no trouble at all getting my RDA.. :) But the situation would look more grim if I were just sitting in a chair all day and eating small meals just because I didn't get hungry enough to eat more.

I'm working on a food delivery service that helps count macro- and micronutrients (in Shanghai).

RDA of magnesium is ~400mg, which is reachable with ~300g of cooked salmon or halibut (~600 kcal), or 350g cooked navy beans (~250 kcal).

An ounce of pumpkin seeds and a cup of black beans and you'd only have to eat 7 servings of broccoli.

I do eat quite a lot of broccoli but I still don't fancy eating 7 heads every day -- enough to cover two dinner plates.

So I take a magnesium tablet before bed. Less work to prepare and to digest.

The present moral aversion to supplements seems faddish to me. We've gone from one extreme in the 1960s where everyone looked forward to taking all food in pill form, like fictional astronauts, to another extreme where supplements of any kind are frowned upon by many including in the medical establishment. Some supplements don't absorb very well, it's true, and some consumers are irresponsible -- yet atoms are atoms and molecules are molecules regardless of the source.

The problem with that sort of suggestion is that by the time you're eating the food that high in this and the food that's high in that and the food that's high in the other, you've gotten to your ~2000 calories for the day and are still missing nutrients, plus your diet is infeasibly bland.

There are some things that if you can't get them from a normal diet are certainly most easily obtained from supplements. Vitamin D, depending on your location, is certainly one. There's reasonable evidence that magnesium is another. IIRC, there's a couple of others where even eating a normal healthy diet won't really get you to where you ought to be. There's also plenty of vitamins where unless you eat a really crazy diet, or you've got some sort of absorption disorder (I'm in that camp so I've had to learn more about this than I really would have cared to), you're never going to be deficient, because you get plenty. Vitamin C, for instance, is effectively impossible to be deficient in. There's a lot of ongoing debate about the virtues of doses higher than "not deficient", but you'd have to go out of your way to get scurvy in the modern world.

Then maybe the RDA is just wrong. If we can't eat enough healthy food to sustain us without becoming obese, then the numbers are wrong. I mean, how could we have possibly made it as long as we have as a species if we are only now realizing that we can't eat enough good foods to be healthy???

>how could we have possibly made it as long as we have as a species if we are only now realizing that we can't eat enough good foods to be healthy?

Partly due to agricultural soil depletion of certain elements like magnesium, zinc, iodine.

Btw our prehistoric ancestors weren't especially healthy either:

https://imgur.com/gallery/2G0BDwx

> Partly due to agricultural soil depletion of certain elements like magnesium, zinc, iodine.

Well, maybe yes or maybe no

https://www.sciencedirect.com/science/article/pii/S088915751...

It wasn't poor health killing people at 30. The leading cause of death at that age was hunting accidents. Besides that and the high infant mortality, people otherwise lived to ~70.

In addition to trukterious' point, which I agree with, I would echo that the idea that the RDA is just wrong is also a distinct possibility. Take a look at this: http://blogs.creighton.edu/heaney/2015/02/13/the-iom-miscalc... Ponder what it implies about the other RDA values. And look at the date. It wasn't that long ago.

I just pulled a fairly recent bottle of CostCo Vitamin D out here, and it's still using a value of 800IU as the RDA.

This seems like an example of the naturalistic fallacy.

Why assume that food with the optimally healthy composition of nutrients exists in nature? People can survive just fine without being maximally healthy.

I didn't say "maximally healthy". It is, however, rather obvious that we were healthy and able to last this long and THUS the foods we had to consume gave us what we needed without having to take supplements.

" So when do you not get enough of it? When you don't eat much food, or not enough of certain kinds of foods."

The exception to this is Vitamin D... if you live in certain areas of the world. In general, the closer you live to the equator, the less you'll need this supplement during the winter. I wound up with a low level last winter - enough to go to the doctor for testing. My other nutrients were just fine: I'm mostly vegetarian and eat fish about once a week.

I have to take the supplements from September through May. The other months I have the choice to take them. If I do not take them, I'm supposed to be outside for at least 15 minutes daily with exposed skin. Minimally short sleeves. I still take the supplements because I wear long sleeves for a good amount of summer.

This is the only supplement I see generally recommended here (Norway) simply because the way the sunlight is in winter.

Vitamin D supplementation is also sketchy and hotly debated topic in. Everyone agrees that it is important, but the currently accepted lower limit and whether you need to supplement if you are below is disputed. That limit was set based on extrapolating observations that were not fully controlled. So that limit has limitations basically. If you are healthy you shouldn’t bother with vit D suppl. If you have health concerns please do, but from a reliable source/brand. Supplements are not regulated.

Depends also on your skin tone. Generally the paler you are the more effective you will be at generating vitamin D at higher latitudes, even if it does result in easier burning.

Those with darker skin in high latitudes typically need more vitamin D in their diet/supplements.

https://en.wikipedia.org/wiki/Hypervitaminosis_D

Vitamin D goes with magnesium, and at higher amounts, vitamin K(2 MK-4).

Both are pretty easy to get, though. I personally eat a lot of broccoli and tend to eat red, fatty fish once a week. Unless the doctor says something, most folks won't need to take those supplements. It is a lot more difficult to meet your vitamin D needs through food, however.

Magnesium deficiency/insufficiency is almost as common as vitamin D's. If status hasn't been verified by something like an RBC or WBC magnesium test, then it isn't really known.

>Say, if you are a vegan with a sedentary life style. You're simply not getting enough of the trace elements through the restricted type of food you eat.

I'm unsure what the sedentary life style has to due with not getting adequate nutrition. A balanced vegan diet generally will easily cover all your bases. The only worry is B12, and even that is easily overcome with fortified milk alternatives.

Just look at Jon's food plans for example. https://www.youtube.com/channel/UCE-LXXVl3u9yJO3WRGTrEoA

Hell, I eat a plant based diet, live a fairly sedentary life style while maintaining a balanced diet, and my full panel blood work taken at six month intervals comes back with no issues.

> I'm unsure what the sedentary life style has to due with not getting adequate nutrition. A balanced vegan diet generally will easily cover all your bases. The only worry is B12, and even that is easily overcome with fortified milk alternatives.

It's easy: You need a certain amount of trace elements every day: Some iron, some minerals, etc. The food you eat contains a bit of that. If you don't eat enough of that food, you don't get enough of the trace elements. A balanced vegetarian diet is fine, but if you eat little (and you will, if you only need, say, 1500 calories a day), you may not get enough of everything. When that's said, maybe you do - depending on exactly what you eat, but as you said yourself, B12 could be a problem.

Go biking - hard - for four hours after (physical) work, and you'll have to eat enormous amounts (relatively speaking) of the same food, and you'll definitely get enough of everything.

The biggest problem is for those who try to live on uncooked vegetables. For some reason they think that it's just the thing, but humans evolved away from that diet a very long time ago, before we were homo sapiens. We don't have the jaws, the teeth, the guts to digest enough nutrients from raw vegetables only. If you live on that, you'll need supplements.

But let's go back to my initial statement: "The general rule is: You don't need supplements." What you are saying doesn't contradict that. What I meant with my too long additonal comments was just that the more you need to eat (e.g. due to exercise), the less supplements you need - if you ever needed any at all. Which is the opposite of how certain "health" and training magazines state it.

>But let's go back to my initial statement: "The general rule is: You don't need supplements." What you are saying doesn't contradict that. What I meant with my too long additonal comments was just that the more you need to eat (e.g. due to exercise), the less supplements you need - if you ever needed any at all. Which is the opposite of how certain "health" and training magazines state it.

I did not present a counter argument for your initial statement. That was not my concern and I agree with your statement.

The main issue was the conclusion you were drawing between a sedentary lifestyle on a vegan diet. Considering vegetables are some of the most nutrient-dense foods relative to their calorie content, sedentary vegans following a diet rich in these low-calorie nutrient-dense foods will have an advantage over people who consume animal meat and follow the same calorie count.

Vegetables are nutrient-dense - no question there. And I was on a mostly vegetarian diet when I did competition bicycling in my youth, simply because I just couldn't get enough nutrients any other way. The problem with a pure vegetarian diet is only that it doesn't cover all your needs, or not completely at least. The trace elements again. If you eat enough of it, no problem in general. If you eat like a bird you may have a problem. And may need some kind of supplements.

FWIW, B12 is something that everyone gets from fortification. It's just that, with animal products, it doesn't need to go on the ingredients label because it gets there by putting it in the animals' feed.

You don't need anything... if lab results suggest nutrients and hormones are all in range.

Last year I was in a hospital renal unit and the guy next to me had had total kidney shutdown from taking to much Zinc - Interaction with other meds they thought.

How do you, or actually how does the OP knows that it is the green tea part of the supplement, and not everything else not otherwise on the labeled that is killing is liver.

The green tea industry is massive user of pesticide, herbicides, fungicide. Extraction process can be sketchy too using re-used solvents. Water in the process can also be contaminated.

“The content of this bottle may differ from its label.”

Always get your nutrients/ antioxidants/ vitamins from its natural form, if you want the benefits of green tea then drink green tea that way you'll get all the benefits from it (water intake, refreshing and such) and will never risk overdose.

https://sciencebasedmedicine.org/more-trouble-for-antioxidan...

Growing evidence that antioxidants are not good for your immune system.

NutrEval, a comprehensive hormone panel, a thyroid panel, and genetic testing. Keeping everything in the preferred range (for a 25 year old; can get more involved as time goes by) may be a better approach.

Iodine protocol. MSM lotion.

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