Supplementation Continued
Why and how one should systematically come off of supplements to test their health improvements.
As always, this is not medical advice, and reading this does not form a client relationship with me - your health is your responsibility.
I will continue reviewing Dr Ling’s “In Search of the Physical Basis of Life” next week. This week, I wanted to discuss a few practical things about supplementation, especially since I currently have multiple clients going through a similar stage.
First Stage of Supplement Implementation
As a review, I think one should start one supplement at a time - this looks like not adding more than one new supplement per day, and I think we should give a solid 3-5 days of each new supplement to notice any immediate and build-up side effects. For those who are sensitive to supplements, and have MCAS/ histamine-related issues, I recommend waiting to start new supplements on days where you do not have to be “on” for commitments, etc. - I would leave at least one day after as a buffer too.
I also think the starting dose should be low - the physiologic dose or less. And one should attempt to drop dose most supplements - taking a physiologic dose frequently throughout the day. Then slowly increasing the total daily dose to the desired amount.
Many will ask how they know they have met the desired amount. This is where one needs to pay attention to how one responds to something. If you go back to the Substack I wrote about equilibriums; I would rather one stay closer to the physiologic dose multiple times a day - so they increase to 5-10x the physiologic dose throughout the day, than to take supraphysiologic doses once or twice a day. Over time, this will alter one’s equilibrium state - hopefully in a positive direction. Though, many have negative or neutral responses to certain supplements. This could be because one is causing a functional deficiency - for example, excess B3 needing to be methylated and not consuming sufficient methionine, Fe, etc. for this. Or, there could be an issue with how the manufacturing practices of the supplement, the fillers, etc. One could also need a different supplement before said supplement. A supplement could be rapidly structuring cells, further taxing excretion pathways, and leading to redistribution in potentially less desirable places - I have worked with many who have not had a good sweat session in years until we started addressing things. Also, many are not having at least a daily bowel movement. And others have urinary tract-related issues. The rapid structuring of cells could require more electrolytes that one does not have readily available. Also, cells will be able to resume production again, which will need amino acids, vitamins, electrolytes, and minerals. As one can see, the possible list of reasons is numerous.
An example with thiamine, vit B1, is taking ~1mg 5-10 times per day = 5-10mg total of supplemental B1. Or my personal favorite is putting ~5-10mg in ~10oz of water or juice (dark and lidded container) and sipping throughout the day. I recommend stopping most supplements by 4 pm, as many can be stimulating. Even if a supplement is meant to assist in helping one go to or stay asleep, I still recommend the 4 pm cut-off the first time taking it. This is also why having two full days can be helpful - if the supplement makes you tired during the day, having the ability to rest will be helpful. Once you note if the “sleep-assist” supplement is actually rest-promoting vs. stimulating, for you, shifting it to the evening and experimenting with how long you take it prior to sleep can commence. Also, I would not suggest most start with even 5-10mg unless they have been taking a B complex with a larger amount with no adverse effects. Many of the people I work with have found that even if they were taking a B complex with 50+mg of B1 (or choose your B) in it, it was way too much once they started drop dosing. And one has to find which form of B1 (or choose your B) works the best for them.
Of course, one can progress more quickly. However, if one goes that route, I would set aside at least one month for the process. Also, I would be monitored by a health care professional regularly for electrolyte, etc, related responses. I am not a proponent of this approach for those with many commitments like family, jobs, etc.
Once achieving the above, one should notice gradual alleviation of specific symptoms related to that micronutrient. For example, three (of many) symptoms that show I need pantethine (a version of vit B5) are:
Overproduction of ketones
Waking up feeling like I was “hit by a bus.”
Keratosis pilaris (no, this is not related to retinol, etc., for me).
This is another reason I think adding things one at a time and leaving a few days in between to see immediate shifts is important. Also, keeping the total doses low, closer to the physiologic amount, helps to protect from creating functional deficiencies of other micronutrients. Making sure one is getting the calculated RDAs from food helps to protect against this too. Keeping a record of which supplement seems to cause “x”-effect or alleviation of “y”-symptom can be helpful. This is especially true for the second stage of supplement implementation.
The following is for those who are using food-based supplements like oyster and organ capsules - I am a big proponent of these over isolated ones, if possible. I still recommend starting one type and only one capsule at a time. After the 3-5d, if one is ready to increase the dose, I would add the second capsule to a time 2h later. As one continues to increase the dose to find their maintenance, the more spread out they can take them, the better - following the drop-dosing idea. However, understandably, life needs to happen. As such, taking that maintenance dose spread between breakfast, lunch, and dinner has been successful for those I work with.
When it comes to supplements that do not taste good, first, I would take this as a hint that maybe you do not need it. For example, various vit B1 forms can taste very pungent. However, one may find that even though it gives them a “face” when taking it, they are drawn to taking it multiple times throughout the day. If you are not drawn to it, either the form or dose is off, or you do not need it currently. For others, finding foods that are theoretically high in the desired compound and eating these for breakfast, lunch, and dinner without dropping the other RDAs, can be helpful - e.g., red muscle meat for carnitine and creatine, etc. A standard dose capsule works if one needs the supplement but cannot deal with the taste. I always recommend when first starting to dump out most of the contents, then putting the capsule fully back together prior to swallowing - so one is getting ~1/6 the total capsule amount. I would still rather take the ~1/6 amount in the capsule multiple times daily. However, this becomes expensive and wasteful unless one can buy more capsules and fill them with the residual. If you do work to taking the entire capsule, I still recommend taking them twice a day and watch for developing downstream deficiencies. Also, please look for supplements that have minimal to no fillers.
** As a general caution, please consider only swallowing one supplement at a time to ensure the capsules do not get stuck in your esophagus. **
Second Stage of Supplement Implementation
** To clarify, I do not start this stage until one has 80+% alleviation of symptoms for 80+% of days over one month. Fluctuations day to day are normal and if we do not know “slow” and “hard” days the “energetic” and “good” days will not stand out. This can take months to years to work through depending on starting state and other factors. **
So, you have slowly built up the supplements you have chosen to take. Now, you are ready for the second stage. Supplements can be fairly expensive, and given all the considerations above, especially the time committment, many want to bring down the total amount they are taking each day. I also love this test to see if one is truly “healing.” This is also why I am a fan of physiologic drop-dosing, so the removal is not another huge swing that may “shock” someone.
There are of course many ways of going about this. For example, one can completely remove a supplement, then wait for symptoms you have associated with that supplement (why it is important to keep notes!) to start to begin again. The moment they do, that indicates the frequency of need for the supplement. For example, when I first started supplement removal testing, I was able to go 2 days without feeling like I was “hit by a bus” when I removed pantethine. That meant, I needed to take the pantethine every other day - I use one day less as an overall “rule.” After staying at that dose for another month or so, I again stopped and found that I could make it 6 days. I continued to do this until reaching my current maintenance which is taking it once every 2 weeks and adding an additional if I begin to feel rundown. This is only one example about pantethine, but I do this for all the supplements I take and with my clients.
For the food-based supplements, I recommend people shift from individual to combination forms. For example, if you were taking individual mushrooms, switching to a combination like Root and Bones or Perfect Supplements, etc. Then from there, you can remove the total capsules you take throughout the day.
You may find there are a handful of supplements you “need” to take daily and others with varying frequencies. As always, I am a fan of focusing on the micronutrients we theorize are needed for the citric acid cycle and electron transport chain. To achieve this, my first go-to is the food-based supplements due to the food matrix, field effect, and whole vs. parts effect. For example, if you need more CoQ10, go for heart; Fe, go for spleen, etc. Then I focus on the individual formations - just B1, etc. After that, there are numerous supplements and combination supplements one can try. In my experience, these can be helpful for specific goals. However, they do not seem to provide the foundation like those shown in the “Hormones Matter” figure. As most know by now, I am a fan of the Pareto principle, and these seem to be the 20% cause that drives the 80% effect when it comes to supplementation.
As always, while one is working on their supplementation, they should be ensuring they are getting the RDAs from food and working on other lifestyle factors including sunlight, sleep, and movement.
Many want to know why this works, and again the theories are numerous. For example, one could be restoring the “transport/ receptor” action. Others could be restoring the microbiome, and they are now making sufficient materials you absorb. Some theorize the light produced by cells can transmutate substances and create what we need. Others may have restored their recycling capabilities. Supplementation may have allowed your body to properly excrete and now keep up with the environmental onslaught. Your lifestyle changes could have led to decreased environmental buildup. The list goes on. And really, the result is what matters - many theorize why, but that does not necessarily mean that explanation is “correct”. Overall, I take the decreased need for these compounds as a positive indication that one is healing
I think one should go down this route given many supplements seem to need to be recycled due to “receptor-down regulation”, increased excretion, etc. For example, many already know this about progesterone.
As a final note, for now, because there is so much nuance to supplementation, as one can see this takes time. Some have spontaneous healing and heal overnight. The majority of people it takes time - on order of months usually. And some take a year to get through the second part. The positive thing is one should notice a marked difference within days of starting a supplement - assuming the right form, dose, and supporting compounds. Also, I think intuition is the most important thing. So many take supplements because someone else told them to, and they do not pay attention to what their body, mind, and soul are actually telling them. I also continue to caution that people do not make the alternative health world a carbon copy of allopathic medicine. We should be looking at the complete picture - how symptoms, labs, etc. all fit together. Versus going the route of “x”-lab means take “y”-supplement.
Many have asked if I do consults. Please see the following: