To supplement or not?

Supplements

Should you take supplements or not?

In September, one of the van Tulleken Doctor and broadcaster brothers claimed that taking supplements is a complete waste of time.

My thoughts, yes and no.

What are supplements?

Dietary supplements, food supplements, nutraceuticals, or botanicals come in a vast range of formats. In the UK they fall under food regulations e.g. require certain labelling standards and must comply with health claim restrictions. Supplements include herbs, vitamins or minerals, or innovative nutraceuticals that simply come in a handy format that we can take daily. Herbal supplements are often powdered herb in capsules, other supplements might be tablets, or even gummies. In the US, some of the more medicinal herbal teas are regulated as food supplements. Supplements can use scientific sounding terms like nanotechnology, Enzyme Q150, AZ1, to make them sound medical and effective.

So I might agree with the Doctor that it is the wild-west out there and most people could do with more helpful information on what supplements are and what to look out for.

Are supplements good?

Yes. Some are essential at certain times of our life. The NHS recommends Folic acid in pregnancy. Vitamin D over the winter months to help keep bones strong. Iron if you are anaemic or have heavy periods. Vitamin B12 if you are vegan or vegetarian.

Doctor van T might be right in saying we should get all of our vitamins and minerals in a healthy balanced diet but we know we don’t always achieve this. As an older woman wanting to look after my bones and who does not drink milk, I sometimes reach for calcium tablets or fortified juices. So in short, many vitamin and mineral supplements can be extremely helpful to us.

I could write at great length on the benefits of many herbal supplements. St John’s Wort is as effective as anti-depressant medications. Andrographis paniculata is a substitute for antibiotics for cold and flu treatment. Ashwagandha is a well established support for stress and fatigue. Many herbal supplements are very well substantiated although there is never enough research to integrate them within medical practice guidelines which is why Doctors cannot prescribe them. So many herbal supplements are also evidence-backed and helpful to us at certain times.

When are supplements NOT needed?

As a health coach my eyebrow raises quite often when clients have been to other therapists and have been recommended enough daily supplements to start a small pharmacy shop! No kidding, one client was taking about 20 different products daily. Not only is this costly, as with medicines, we do not know how these are interacting in the body. Quite often cheaper supplements are also quite poorly absorbed so either won’t get in, or if you don’t need them all, the body will simply pee them out. Expensive pee eh!

Do you want my 40ish year’s worth of experience?

You should not be taking 20 daily supplements. I would worry that a client was taking 10 or 5 every day. What we would do is explore their foundations of good sleep, good diet and good exercise. This is where I agree with the Doctor van T, there are over-zealous therapists out there making recommendations as if they were selling packets of Smarties, and the wellbeing industry is a £ multi-billion one, and very good at marketing products. At this moment you may have noticed vigorous advertising to older women – selling you solutions for the perimenopause and menopause which are increasingly marketed as if they were disease and they are peddling to our fears. Menfolk, watch out, your time is coming.

If you are living and eating well, there may be one or two supplements you might take daily, or keep in your kitchen cupboard until you have a specific need. I take calcium and omega 3 oils occasionally, and herbal remedies when I need them. But not every day.

How to select supplements

Listen to your body, not anyone else, unless your own Doctor or Pharmacist is recommending something that you need. If you are needing a supplement then try and buy the most expensive version you can from a reputable stockist, and be very cautious if buying something via Amazon where the quality of the product may be questionable. Do research the brands and companies you are buying from. Cheaper supplements may have fillers and preservatives in them and contain very little active ingredient. Do look at the ingredient lists and Google anything you don’t understand.

Do go and speak with your Pharmacist – they are incredibly knowledgable people not just about pharmaceutical medicines but supplements too. They will give you good solid advice. Alternatively if you are paying for a therapist, do make sure they are registered with their professional body at least for some reassurance, and do ask as they might have accounts with supplement companies or sales platforms and receive a cut.

Summary

Many supplements are backed by research and play an important role in keeping us healthy. However, these are “supplements” and not “replacements” so should not be a substitute for a balanced diet and lifestyle. If you are on more than two each day I would question that. If you have a small supply of go-to remedies in your cupboard that you use on occasions that is absolutely fine.

I’m personally very disappointed in the Doctor van T as he usually has a very balanced perspective, but I do believe he is just trying to sell a book.

Some swaps to try:
Probiotics – take a spoonfull of natural yogurt every day.
Vitamin C – forage for autumn berries and make a spicy rob.
Prebiotics – eat spices, prunes and other soft fruit.
Omega 3 – tins of sardines or mackerel. (Added benefit of calcium and protein).
L-theanine – have a cup of black tea.
Digestive enzymes – eat more plant bitters e.g. chamomile, dandelion, bitter tonics before meals.
Anthocyanins – red cabbage or beetroot anyone?
Some mega / neuro sleep product – chamomile tea.

Good night.

Keto, low carb, fasting – what’s what?

Keto food

Over the summer I have felt my tummy bulge and I’m experiencing dizzy spells for the first time ever. Might that be the heat or should I understand my body a bit more? For years I’ve been intrigued in the ketogenic diet, and some of the people I work with are Doctors and talk about its medical use. I’m wary of us doing anything dramatic on our own with out medical help, so thought I’d explore it more gently for myself.

Fasting, Fasting mimicking diets (FMD), “going keto”, “low carb”

These ways of modifying our food intake are are all over the internet. They are being researched for their health benefits which gives me reassurance. This article has some simple thoughts from me, and I’m coming from the perspective of mid-life people developing a bit of a belly, and not if you are pre-diabetic or have a known medical condition.

What is fasting?

Fasting gives your body a rest between meals. It helps us away from our snacking culture (which the retailers want you to have, as snacks are big business ££). Can you eat an earlier evening meal and go through to breakfast – brilliant, that’s a 12 hour fast. Can you eat early evening and go to lunch, then that’s a 16 hour fast. People do fast for longer and days at a time, but I would not attempt anything without medical help, and it’s the sort of support we wouldn’t get in our rushed NHS service. So do a tiny step first.

Reduce your snacks or swap sweets or chocolate for nuts, fruit, carrot sticks.
Try and fast overnight for up to 16 hours.
Keep this going for 3-5 days to get into the habit of a more healthy eating pattern.

Fasting-mimicking diets

These are quite expensive food kits that again are used in medicine for a quick and reliable response for some patients, and they provide all the nutrients you need and food you need to fast for 5 days. They are expensive so I’ve not tried them, but my work colleagues have and experienced headaches and felt lethargic. Not for me.

Low carb

Low carb is advocated by the Low Carb GP Dr David Unwin and I’m a huge fan of how this simple approach helps people who are pre-diabetic or have Type 2 Diabetes. Again, helpful under careful medical supervision, but you can introduce the principles if you are me – mid-life and paunchy! Keep a food diary to be honest about your sugar intake, fizzy drinks, that odd bit of cake here and there. Cut it out! Do not eat white starchy food like potato, pasta and rice. These are scrummy, comforting and filling, but they rapidly turn into glucose so its like taking a huge sugar injection. Eat brown rice, brown pasta, and by focusing your meals around the protein with veggies, you will not go hungry. I eat lower carbs most of the time, and will eat half the carbs compared to others, or if eating out, sometimes none at all.

 potatoe

My favourite – mash potato. Now for special occasions not every day.

Monitor  your sugar intake by keeping a food diary.
Watch the white pasta, rice or potato – switch to brown.
Ensure you eat wholesome protein and veggies to fill up.

Ketogenic diet

There’s the idea that in prehistoric times we wouldn’t have eaten carbs as we did not cultivate wheat and potatoes. I’m not so sure – plenty of wild plants have starchy roots which we may have eaten. That’s one of the justifications behind the keto diet. Another is that like going low carb, it reduces the sugar and carbs we take in. The idea is to minimise carbs to 20 g a day (a slice of bread, half a baked potato), and to focus our meals around protein, fat, and non-starchy vegetables. Fruit contains sugar so we need to be careful. So it is a bit more of a radical change than just low carb.

What’s happening in our body? In our cells the chemistry is switching from using glucose to create energy to using the protein and fat to create ketones. Our cells use many different types of fuels not just glucose which we are probably most familiar with from learning about respiration in GCSE biology. Ketones, short-chain fatty acids from the gut bacteria, and even compounds from alcohol are all fuels that our cells can use. Ketones are interesting because they help us recover from relying on glucose for fuel, and the critical part, is they steer us away from pumping out insulin all of the time. So this is great for me as my belly is a sign I’m moving into the poor metabolic health zone. Belly fat suggests there’s fat around my abdominal organs, and it can be a sign that poor metabolic health is coming. So I want to stop that now.

How can you achieve a ketogenic diet where you “go keto” and produce ketones in the body? I’m guided by Dr Annette Bosworth, a medic in the US. Here’s a link to a podcast she did that I think is a good listen. (Do be wary of these longer-style podcasts as I feel people can overshare more faddy and radical ideas that would not be backed by science). She pushes her patients though quite a strict programme and I wouldn’t do this unsupervised. I’ve gone for a gentler approach.

No sugary snacks – they’ve gone
Low carbs each day, and darn, zero beers contain carbs.
High protein each meal
High fat
Plenty of green veggies.

I’m not religiously avoiding fruit and veggies as what I dislike about the keto is it can be low fiber which is not healthy. I fast until lunch and then go for tins of fish, nuts for snacks, cheese and eggs or a little meat for evening meals. I’ve upped my fat intake which again is contrary to what we’ve been told. I go for a bit more butter and olive oil on salads, but I’m not eating high amounts of fat advocated by the keto diet. I might introduce more in the weeks to come.

I have used an online tool to understand what carbs are in different foods. The Chronometer App is free, and after you’ve plugged in your meals for a few days, you get a good idea of what’s in the food you are eating. I was surprised that zero (alcohol-free) beers still contained carbs and 3 pints took me over my recommended 20 g of carbs a day.

The results? I’ve maintained this for 2 weeks. Gone from 10 stone to reaching 9 stone 9 on the scales at one point. I’m not doing urine ketone tests every day, but today was pink showing low to medium levels of ketones in my body. (The strips were £10 off Amazon for 150). I must say I feel great – sleeping well and am full of energy. I can be on the computer concentrating all day and have no brain fog. I feel happy. But to be honest, I probably was before. I’d be interested if this helps over winter where my mood does drop. I’m going to stick it out and hopefully this will be how I eat from now because it is just delicious healthy food. It feels so good to not have the sugar all the time.

Ketone strip

Here’s the ketone strip – its very easy to do. Dip into your wee and watch the colour change. Here’s a darkish pink showing ketones there – yey.

What if you want to try one of these approaches?

I think you can explore any of these ideas gently by yourself. Don’t spend lots of money on measuring devices and gizmos. The diet packs are pricy but perhaps that’s the right choice for you. Follow the links I’ve suggested and do some reading. If you are living with an illness or know you are pre-diabetic, find a nutritionist to help you, or an integrative medicine doctor who might have a practice local to you. You’ll have to pay for this though.

These are all just sensible and healthy ways of living, or you can dip in and out for a few weeks at a time. The great news is, there is research helping us understand what is going on in the body, and some health professionals deciding to share their knowledge to help us.

What is one thing you have learned?
What one thing might you change today whilst you read more?

Summary

  • Fasting, Low Carb and Keto are different eating patterns that research suggests can help us live more healthier. People report better concentration, better sleep, better mood and weight loss.
  • They are sometimes used under medical supervision to help with conditions like Type 1 Diabetes.
  • Fasting helps us think about our eating patterns and our snacking habits.
  • Low carb and keto rely on reducing the sugars and starches in our diet in order to reduce glucose (which drives high insulin levels and dominates as the main fuel in cells).
  • Planning your meals around protein and eating healthy fats is a good starting point to ease you into making changes to your diet that you can sustain.

How to heal swollen gums

Arnica flower

There is nothing more irritating than experiencing an ulcer or gum damage in the mouth. Healing is difficult as obviously the mouth is in constant use. I’ve had a persistent sore at the back of my mouth for it must be over 4 years now – the dentist has no suggestions of what to do, and the gum does not sealing against the tooth.

What makes it worse?

For years I would brush vigorously with toothpastes and use mouth washes every day. I stopped the mouthwashes when the dental hygienist told me they stain the teeth. If you read the small print on the label, that is indeed correct, so I stopped the mouth wash and no longer need the hygienist to scrape away at the brown stains. Lol. I then read about sodium lauryl sulphate (SLS). This is a detergent that is used in toothpaste to make them foamy. And guess what, it can irritate gums. Some people experience ulcers as a result of these products.

There is research into SLS that shows that using SLS-free products can reduced the number of ulcers, how long they lasts and the level of pain that people experience (Alli 2019). Wowzers. That’s quite significant. Maybe in people like myself who are susceptible, going SLS-free is sensible. In fact I don’t use any dental products now containing long lists of chemicals and there’s been a remarkable difference in the dodgy bit of my mouth. I use Weleda toothpastes . No nasties there and just lovely herbs.

Flare-ups

There have been two horrible occasions when the back of my mouth has swollen so much I could not close my jaw. The first time I was given antibiotics which I hate taking. The second time was last week at Gatwick airport when I was about to fly off on holiday. My gum was blowing up like a balloon and I was about to play the saxophone for a week. I bought some Bonjela thinking that’s the right thing to do and it aggravated everything so much that I couldn’t close my jaw. I was seriously thinking I’d have to go home.

Arnica to the rescue

Ironically I’ve been researching Arnica for two years now and give talks on the research. One good use for arnica gel and homeopathic arnica tablets is for the relief of dental pain and swelling after tooth removal. There was a clinical trial published only last week on this. The study showed that homeopathic arnica eased pain and swelling in people who had had molar teeth removed.

So at the airport I had nothing to lose and got out my Weleda Arnica Oil and dabbed it on my mouth. My past experience of having antibiotics is that it took 3-4 days to even start to reduce. To my relief and amazement, by the end of my flight I could close my jaw, and the swelling eased rapidly over the next few days. I would dab the Arnica on between meals and tried not to drink anything to give it a chance to work.

What I would say is I was extremely cautious to only put a small amount on my finger, as we shouldn’t ingest Arnica. Weleda do homeopathic tablets and a lovely range of dental products, but I did not have anything else with me.

Other herbs

When I’m at home to help with swelling and healing I use plantain that grows in my lawn. This is great plantain (Plantago major) with the wide ribbed leaves. They are full of gooey mucilage that helps bind wounds, and also contain flavonoids and tannins which help fight infection and reduce inflammation. I pick a fresh leaf, wash it under the tap and then chew it and place on the gum for about 5 minutes. Voila.

I also use Triphala which is an Ayurvedic remedy of three fruits which is a bitter powder. Triphala is great for the gut, but I dissolve a capsule in warm water and use as a mouth wash. It is researched as a mouthwash to help with root canal treatment, and I use it before bed to rinse round when my gum is bad.

Tips for gum health

If you have recurring ulcers or sensitive gums, check the chemicals in your toothpaste and mouth wash. Can you switch to non-chemical alternatives to avoid the SLS?

Arnica oil or mouth gels may help relieve swelling and pain if you are having a gum flare-up or have had a tooth removed.

Other herbs like plantain (Plantago) and Triphala are also researched and may help heal gum flare-ups, or be helpful for general mouth hygiene.