Supplements
A different paradigm than trading allopathic medicine's pharmaceutical approach for alternative medicine's supplements
As always, this is not medical advice, and reading this does not form a client relationship with me- your health is your responsibility.
Today's newsletter will include an update on my intuitive fat-loss phase and a discussion on my stance on how to go about supplementation. So please feel free to skip to the parts you want to read.
Intuitive fat-loss phase end of week three update: On Monday, 17 October, I averaged 114.0lbs. I did have my usual ~2lbs increase up to 116lbs on the first day of my period. However, on the second day, I was back down to 114.8lbs. So, Monday to Monday (10 October to 17 October), I am down another 0.9lbs or 0.78%. Given this is week 3, I dropped a cardio session from 4 to 3 per week; my biofeedback markers, like waking temperature and NEAT, etc., are still holding; I take this as a successful fat-loss phase so far. I would argue that the time I spent reverse dieting, then at maintenance, is why this phase seems so "easy." I am looking forward to the remaining three weeks of this phase.
I have had numerous questions about my stance on the following:
Start one supplement at a time
Start said supplement at a low dose
Build said supplement slowly
My overarching reason for these statements is how I see the body - the body looks for homeostasis. This does not necessarily mean that one's current homeostasis point is a globally stable equilibrium. One could be in a local stable or unstable equilibrium. I do not intend for the collective groan due to a quick foray into physics, but we need to discuss stable vs. unstable equilibrium, global vs. local, and limit cycles.
Critical points are also known as stationary or bifurcation points. These points, known as maximum, minimum, and saddle points, tell one about their system. In physics, we usually look at stable and unstable equilibrium. For example, a maximum point would be an unstable equilibrium because if I give a little "kick" to a ball resting on a hill, the ball will go rolling down the hill. However, if I give a "kick" to a ball in the middle of a valley, a minimum point, the ball will oscillate about the point and rest stationary at it. A saddle point, also known as a minimax point, combines a minimum and maximum equilibrium. Much like a horse's saddle, if I kick a ball in one direction, it will fall down the saddle like an unstable equilibrium. However, if I kick the ball in another direction, it will oscillate and return to rest at the point, like a stable equilibrium. Please see the pictures below representing maximum, minimum, and minimax equilibrium.
After accounting for the stable vs. unstable equilibrium, we look at local vs. global equilibrium. In biochemistry, one of the best examples is looking at the activation energy for a reaction. The activation energy is essentially the system's inertia- or the system's resistance to change. From a more macro view, the activation energy is like the initial effort it takes when we decide to start a new habit. Based on the habit, etc., the energy needed is higher, much like the energy needed for a reaction to proceed. And like our habits, the requirement for greater activation energy usually leads to a slower reaction - so the more energy a new habit requires, the longer it takes to become a habit. In our bodies, enzymes help lower the activation energy needed. Lowering the activation energy would be to have someone or something help us to achieve our goal of a new habit in our habit example. Now we move to global vs. local equilibrium because I can put energy into the system to bring it to a locally unstable equilibrium. Then I need the slightest amount of more energy for the reaction to proceed. The reaction then forms new product(s) at a new energy. The new energy is now the new local stable equilibrium point. However, to be at a globally stable equilibrium point, I could provide my system with sufficient energy, usually with the assistance of enzyme(s) (or some other external "help" in another system). Once a system is in a globally stable equilibrium, it will return to that point if perturbed ("kicked"). One can see the globally stable equilibrium with the limit cycle diagram - regardless of the system starting point and trajectory, it always converges to the same equilibrium. However, there is also globally unstable equilibrium - these are very dangerous for our health. These ideas apply to every system - financial, etc.
At this point, most are probably wondering how the above applies and if they should stop reading here. Let me explain: many, especially those who are very "sick," etc., find themselves in a local unstable equilibrium. When one is "spiraling into death," they would be in a globally unstable equilibrium - if, for example, there is irrecoverable damage to the heart and/or brain, uncontrollable bleeding, etc. The body has an immense capacity to heal; however, these more "acute" structural things are usually self-limiting. Yet, some have survived them, so please, never lose hope. Most of us are looking for the nearest local stable equilibrium and working towards the globally stable equilibrium over time. One can handle the amount of "stress," "deviations from the norm," new food, new supplements, etc., dependent on the activation energy needed to kick one out of their locally stable equilibrium. The person in globally stable equilibrium is the one who seems as if they can do and eat anything while having an "appropriate" response to stress.
In summary, the body looks for homeostasis. Therefore, whether you need something or not, swinging from one end of the spectrum to the other does not seem to work well. What does work is adding things over time. I say this with the big caveat of your state. If one is heading towards a globally unstable equilibrium, I highly suggest seeking a healthcare team to monitor you as they replete you.
1. Start one supplement at a time
When many start their health journey, they see all of the influencers, coaches, naturopaths, doctors, etc., espousing the almost "miracle-like" properties of certain supplements. Others may have followed one "health" paradigm, decided it was no longer serving them, and "jumped" to another. Back to my homeostasis argument above, this could be "shocking" to the body, even if one needs what the new paradigm espouses - think jumping from raw vegan to carnivore. This new paradigm many times comes with its new supplement recommendations. There are some cross-overs, but many times they are different. So we start all of these new supplements simultaneously; many are complexes. One of the first issues with this is many complexes contain similar ingredients for their base. These combinations can cause one to get too much Vit B6, zinc, etc. Many will claim one cannot get too many B vitamins because they are water-soluble, and we urinate out the rest. However, if one has hypophosphatasia or another reason for vitamin B6 toxicity, they know how untrue this is. Another reason could be insufficient vitamin B2, B1, etc. Also, the issue is not only the high dose and the pyridoxine HCl versions of B6. I have spoken to many who get "B6T" with P5P and a very low dose (I do). Many, especially with a pituitary tumor, do well with B6, so I am not saying one should never take it. I discussed some issues with taking Zn independent of sufficient other divalent cations in last week's substack (12 October 2022).
The primary problems I see with starting multiple supplements and/or a complex at once is you do not know what is helping you; what alleviates which "symptoms,"; and there may be one supplement that is negatively affecting you, with some others "making up for it." I am not saying one should never take supplements or complexes. At one time, I could only eat rice with a particular brand of tomato sauce. As such, I required supplementation to get the RDAs. Some need to go this route too. However, once new food is tolerable - usually, this requires following these steps as well - it should be eaten and not removed. I am not a fan of "elimination diets" for this reason. Or am I a fan of removing most foods based on food allergy tests - even with MCAS. Of course, if one may become anaphylactic to something, remove it. However, in my experience, people remove foods, then produce new or more antibodies to the foods they primarily eat. Then they must remove more foods until they eat less than ten foods. I would follow similar steps to those laid out here for supplementation when reintroducing foods if you find yourself in this situation.
I think one can and should build multiple supplements together. However, when I caution starting one at a time, I mean do not start multiple supplements in one day. Building B1, B2, B3, and B5 together as an example. If one has not had a negative response to a supplement in the past, doing something like:
Put in a dark bottle with a lid ~10-12oz of water or juice sipped throughout the day - I usually advise stopping most supplements before 4 PM in case they give you insomnia, etc. Some help with insomnia, which creates another step for figuring out what time of day you do best taking a supplement. Potential effects on sleep are also a reason for starting only one new supplement daily. The new supplement may make you drowsy and need to be taken closer to bedtime. Sleep effects can become dose-dependent, so building multiple supplements can make things "murky." If a new symptom seems to arise from a dose-dependent nature, consider taking a few days and trialing them individually to see which one is the cause. The subphysiologic dose often mitigates any potential drowsiness, excitability, etc., responses.
Day 1: 1 drop of B1
Day 2: 1 drop of B1 + B2
Day 3: 1 drop of B1 + B2 + B3
Day 4: 1 drop of B1 + B2 + B3 + B5
Day 5: 2 drops of B1 + 1 drop of B2 + B3 + B5, etc.
If one has had a negative response to the above, I would consider any other ingredients with the solution, the form used to go even slower, or the absorption path (sublingual, by mouth, topical, and even enema). For example, I do best with thiamine mononitrate; others I have worked with do best with benfotiamine for vitamin B1. Also, if you are not already getting the RDAs from food, doing a slow reverse diet until you are while building your supplements can be incredibly helpful, too - especially for the electrolytes.
2. Start said supplement at a low dose.
I usually recommend a physiologic dose taken multiple times a day. The physiologic dose here means less than or equal to the recommended daily allowance (RDA). Some need to start with the RDA, 1/10, 1/100, etc., so please pay attention to your reaction after starting a supplement and adjust accordingly. If you have an "acute" response to one supplement, I assume you will have one to another and would advise starting even lower than the RDA. Drop-dosing has become my go-to recommendation for most people I work with and myself. How I drop-dose is to put the supplement in ~10-12oz of water, juice, water+juice, and sip throughout the day. If you take anything with vitamins B2, B9, and/or B12 in it, I suggest using a dark container and sipping out of the sunlight. I found a B complex that I do well with and do this using water. However, I do not mind the taste of the B vitamins; many do not. Also, I individually built the Bs first to know which ones and what form I do and do not do well with. If you choose a complex with thiamine tetrahydrofurfuryl disulfide (TTFD, also known as allithiamine), prepare for the most pungent garlic taste you have ever experienced.
The supplement may interact with whatever is in the water and/ or juice. So this is another thing to be cognizant of. Especially if you go with one source, then change, your response to the supplement "could" be different. The likelihood of a chemical reaction is fairly low because many need heating, enzymes, etc.; however, it is something I consider. And, assuming your stomach acids, pancreatic enzymes, etc., are "up to par," they should be breaking everything down to their constituent parts anyways. One could look up the possible chemical reactions if one were truly concerned. Also, these things are already found in food matrices; they would "see each other" if in the stomach together, anyways. I do not let this "keep me up at night." Or cause more "paralysis" by analysis.
If you are using something like organ supplement capsules where the recommended dose is six capsules per day, you could start by sprinkling ~1/4 of one capsule on four different meals and building from there. If you already know that you do well with taking all six at once, then consider taking one capsule six times per day or two capsules three times per day, etc. I have found liquid formulations to be the easiest when drop-dosing if you do not want to sip on a solution throughout the day. You can use these sublingually instead of explaining to family members why they cannot drink out of your bottle. A few companies sell individual minerals and vitamins as a liquid. You can also buy bulk powder and make up a week's worth at a time in a glass dropper.
3. Build said supplement slowly
This goes with point 2. I do not think people need to “feel worse” before “feeling better.” If anything, the supplements can structure cells too rapidly for the detoxification and excretion pathways. Because the pathways are now overwhelmed, the body has to find another place to "stash" whatever is "excluded." Or it has to decide what needs to be excreted "now" and what can "wait." The process repeats every time you take a new dose, and more global structuring occurs. The process is especially true if the body constantly accounts for what one is continually poisoning oneself with - most times unknowingly. This approach arguably takes more time; however, most are going about supplementation alone and cannot afford a further health decline.
The other issue is the micronutrients are all needed. And if you take a supplement, not considered a micronutrient, it will still interact and need the other micronutrients, etc. Many have experienced this "referring type reaction" in the B12 and B1 worlds. When one starts adding B12, there is a major draw on potassium. The B12-K dependence can be for many factors, including making new red blood cells, aldosterone, etc. With B1, many find they need more magnesium, taurine, and B2. Eventually, one finds they need every micronutrient to have an optimal relative relation. For example, when B1, Mg, cysteine, ALA, B5, and ADP allow pyruvate to "advance into" the citric acid cycle via the enzyme pyruvate dehydrogenase (can also go the pyruvate carboxylase route to oxaloacetate, which needs Mn and biotin) to form acetyl-CoA. The enzyme citrate synthase then allows the acetyl-CoA and oxaloacetate condensation reaction (addition of water) to form citrate. The water for the reaction arguably comes from the production of water via complex iv of the electron transport chain because both the TCA and ETC occur in the matrix of the mitochondria. We need every other micronutrient, macronutrient, and arguably the hormones and neurotransmitters for water production. Though I see the hormones and neurotransmitters more as a "note," something happened. The NAD+/NADH need B3; FAD/ FADH2 need B2, thyroid hormone (Se, I, tyrosine, Zn, etc.), Mo; Succinyl-CoA can also be formed via the branch chain amino acids, odd-chain fatty acids, and cholesterol via propionyl-CoA which needs biotin and methylmalonyl-CoA which needs adenosylcobalamin (a form of vitamin B12). As you can see, there is a web of interaction between everything. As such, those who argue you only need Mg, thyroid hormone, etc., are missing the forest through the trees.
Please refer back to 1. for an example of how to build B1, B2, B3, and B5 together.
There is a lot more to note about this subject, including:
Giving the body ~physiolgic doses of supplements throughout the day will give the cells and the various microbiomes multiple chances to have what they need. This goes into the idea of when certain organs are the most “active.” Also, our circadian rhythm, etc. Due to transport protein, “receptor”, “channel”, etc. issues if the goal is to restore intracellular amounts, this is the most important reason I think drop-dosing is the way to go.
The body must deal with excess supplements - for example, extra B3 must be methylated. Many are not consuming sufficient methyl donors as it is, which puts another stress on the bodies limited resources.
In conclusion, many do well taking high doses of supplements. However, I would caution what this may lead to long-term if you do not high-dose every nutrient. Many have traded the pharmaceutical world of allopathic medicine for the supplement world of functional and alternative medicine. The same can be said of supplements as is argued about how pharmaceuticals were never meant to be taken long term and have never been studied in combination. We face significant issues due to top-soil concentrations, our microbiome production, and subsequent absorption, etc. However, how I have seen these things dealt with is supplementing back to a positive biofeedback baseline. At the same time, do a very slow reverse diet and prioritize nutrient-dense foods as best as possible - with the understanding this is many times just a zeroth order view. Then once one's symptoms have normalized, only supplement when needed - a maintenance dose. Supplementing when needed can look like taking things once a week, spread out from each other. Or only when a specific symptom arises - the good thing is you took the time to figure out what supplement seems to positively resolve which symptom, so you will know what to reach for. Also, if you pay attention to your body, you will eventually realize you are drawn to a specific supplement, food, place, person, etc., and are repulsed from those you do not "want or need" at that time. If one has access to a garden or farm and can put individual minerals in the soil, the plants will take them up and transform them into a food matrix for us and our livestock. The ground and animals' microbes make the vitamins and provide us with macronutrients.
I understand these steps take a lot of time. Also, the body is dynamic, as is our relationship to our external environment - flying across magnetic field lines and into different time zones, eating food not grown in our local area, the changing seasons, hormonal cycles, etc. As such, you may need a supplement for a season and then another, the next. However, the amount of information you will learn about yourself, your needs, what supplements address which symptom, etc., is invaluable.
*All figures found from a google search and do not belong to me.