Dear Dietitian – Supplement Recommendations for Clients

Dear Dietitian – Supplement Recommendations for Clients

November 12, 2019 0 By William Morgan


Alright so next question, would you regularly
recommend supplementation of a clients diet? If so what supplements? Just general supplements. Just general, so if someone comes in and they’re
taking, they’re over 50s vitamin, they’re on Vitamin B or Vitamin D and all that sort
of random stuff. So would I? Would you prescribe a supplement to anyone
without any additional information? No. Nah. Sorry often- Expensive piss. My job is taking people off supplements, there’re
other issues around that too because a lot of tests that we have access to they’re not
extremely reliable when they’re measuring someones deficiency or their excess status. So there’s lots of ways you can test micronutrients,
be it in the urine, the blood and the serum. Hair analysis, all the above, and depending
on the nutrient some of them are better tested in different forms. So if the GP just does full blood work of
all of their vitamin and minerals it may not be evident and you might actually get, this
ones high, this ones low and it’s not a true indicator. So what is a true indicator? Like irons a really good one, if someones
taking iron supplement they actually, it’s just going to appear that they’ve got normal
iron. They might actually be deficient in their
stores, obviously then you can check Ferritin, you can check their- Transfer. Transferrin but yeah, again the MCV, those
types of things. But there’s also a lot of influencing factors,
so you know a good example is say something like a Selenium for example is really quite
accurately tested through hair analysis. The issue with that is that we can’t do that,
and it’s not a valid true indicator of someones actual deficiency there and then. Dead bit of hair, I don’t agree with that
whatsoever. Yeah, so there’s actual [inaudible 00:02:07]
to suggest it’s a good way to measure it, but its old data. I didn’t realise you were in a trap. I practise in an evidence based space so I
don’t do that test and if you are going to have that test done, it doesn’t give you a
clear picture. All I’m saying is it gives you an indicator
of true deficiency. So if someone was taking a supplement and
they said, I’m deficient in magnesium that’s why I’m taking it. What is your next question? Have you actually had that tested? Then they go, yes. Then you go, how? Yeah. I say, blots, and you go what? Oh yeah, so do you have that number on me,
have you talked to the doctor about it? Has he prescribed anything? So obvious one is iron, and obvious one is
Vitamin D. A lot of people will be supplementing Vitamin D just because. But again treating a deficiency that’s not
actually optimal. At the same time I’m not necessarily going
to stop someone, like if they really want to take it, it’s not going to do too much
harm. So the only ones you just need to be careful
about is sort of overdosing- Or iron. … soluble vitamins, yeah. Well yeah, you hope they’re not taking a bunch
but. Well yeah, a lot of people are. People that we work with obviously specifically
would be our bariatric clients and I would always then pop them on a supplement specific
to, a lot of them come on a pregnancy pre conception and post conception vitamin. Because they’re often a little bit cheaper,
not much. There’s way too much iron in a lot of those
pregnancy ones and they end up getting really bound up. Worse so because they don’t eat much- Meaning they can’t go to the toilet. Pretty much, and iron is influenced by the
absorption so it doesn’t matter whether you’ve got a heap of it in a supplement, you’ve only
got to absorb this much through the gut. So the rest contributes to you being constipated,
obviously not everybody gets constipated but be really careful with iron supplementation,
’cause people are really intolerant to iron in large loads. So you’re better off to actually go a lower
end of the spectrum. Do your supplement Omega threes, fish oil. Regularly. In the past if someones presenting with high
Triglycerides, yeah I do so regularly. [crosstalk 00:04:38] That will be the only
time if they’re coming to me with blood work or they’ve told me in the past that they’ve
been deficient in this but then they never actually went on any medication for it. Again if that was six to 12 months ago, I
don’t care, I’d probably go you probably need to go and get a retest and see where it’s
at before I say, oh go on Mega B-12. Go and get your follow up levels tested et
cetera. How often do you like in terms of a multi-vitamin,
other than bariatric clients, how often do you recommend a multi-vitamin? Nah, never. I would always try and optimise their diet
first, so look at some nutrients in their diet. Maybe put it through software. If that was like, nah I want to take it. Fine, I don’t care, take it. That’s okay. Sames. Yeah. Just like save your money, don’t need to do
it. You need all of this. Well look a lot of people find that they do
get a placebo effect from taking anything. Yeah, that’s what I mean, if they’re passionate
about. Oh I want to take this, well if you take it
away they’re probably going to think that what you’ve done is wrong. So let them have it, and then they go, oh
yeah I feel amazing. Yeah, it’s like a discussion I had with some
friends the other night and this guy had prostate cancer. He decided, well he was pretty much on death
row, they told him to get his affairs in order. He was a really fit guy, I used to play squash
with him when I was younger. He told me that his PSA levels are now back
to normal if not just amazing. What’s PSA? Prostate specific antigen. His PSA was just off the charts to start with
because he was ignoring his symptoms, peeing and not being able to keep it up and all that
jazz. So he has- Your conversation has gone from playing squash. Yeah I know, anyway, so but they would be
the things that he would be suffering from. Most men don’t go and get that sorted, treated. Hence why you’re not with PSA levels from
the wazoo, he also had a really aggressive type of prostate cancer. Anyway so two years out and he’s in remission
and things are looking good. But he was on the raft, like the tumeric,
he was on something called Aseya, and if I didn’t know about it, I was like is that Asaye. We’ve had this conversation at the table. The thing about it is that when people are
taking such a broad range of supplements- What’s working? Exactly, like did you specifically test that? The thing with people is you can’t go, oh
right I’m going to withhold this medication, I’m not going to give you chemotherapy. ‘Cause he also had chemotherapy, so that may
have worked. Then individual test that nutrient, and that
one and that one, but what if that person falls off the perch, and this person stays
well. Also you’ve got that individual uptake of
nutrients, which is also very different. The usual response to chemotherapy. The type of supplement, like Chromium for
example, and Selenium can all come in different forms. Calcium can come in different forms, which
are better or worse absorbed. It’s too many uncontrollable factors, so therefore
it’s really hard to do any controlled research in supplements. Rabbit hole, so pretty much no, we don’t often
recommend supplements. If we did it’s sparingly. So cholesterol, fish oil. I would make a recommendation if someones
come to me and they’ve complained about not tolerating a supplement well. So Vitamin D, or like iron for example is
a common one that I would say. ‘Cause a lot of the time they haven’t brought
up these issues with their GP, I can guarantee you that, ’cause I often ask them that question. Oh no, I didn’t tell them I haven’t been to
the toilet for five days. I just took Slim Coloxyl and I’m okay. Or yeah I’m just getting … Or this Vitamin
D supplement is painful, it gives me pain or I forget to take it, if someones got instilled
osteoporosis you can get an injection for iron, you can also get an injection for Vitamin
D and all the above. Which improves the absorption, decreases the
risk of someone not taking it, so that I would recommend back to the GP. Have you considered all this persons, telling
me that they’ve got issues with the tolerance to medication. Then in terms of sport and athletes, nope. Not often, and getting jacked, link or there,
over here, or down there. But yeah so no, not often. But if I did then yeah those common ones that
I would based on that person and their sport, and their goals and their level of performance. Their level of training, their level of sport,
whether is a league or sub amateur. Yeah, so all very variable, all individual
but yes I will recommend it for the right people but it’s always food first. Tick all those boxes and then again like Peta
was saying about what supplements work, it’s just like or if you did it, you don’t go and
just go alright now I’m going to get you to have five different supplements all at once. ‘Cause you don’t know which ones actually
going to make them feel better, if they come back, oh yeah I’m going, but they’re spending
100 bucks a month on sups. It’s just like well- It’s like I was talking to one of the practitioners
yesterday actually about this, ’cause there’s research coming out all the time. Chromium, cinnamon, all that sort of stuff
for diabetes and glucose control. The question was, oh well how much? Do you just put them on it? I’m like, well no, you have to see if they’ve
got any obvious deficiency to start with, and if their diet is not adequate you wouldn’t
just go, have that. Again, it’s not really our scope either, but
there’s [redecent 00:10:10] textbooks, because there’s a bit of WhatsApp conversation with
our team lately about it. So I think there’s a good evidence based on
herbs and supplements, good textbook. Ah yeah, yup. Complimentary medicines and alternative therapies. It’s good to have an understanding at least
to be able to rebut any ridiculous claims like tumeric for example, which is huge at
the moment. There’s nothing to suggest that it’s supposed
to be treating disease either. There’s nothing warranting that, and also
there’s no dosage amount that is legit, or set. So people were just having tumeric in all
way, shapes and forms, which cool because- Or flavour. Great, but it stains your teeth, so be wary
of that. You’ll end up with yellow teeth. So what coffee drinkers plus tumeric, so those
tumeric lattes- Disaster. Yeah I know my [inaudible 00:11:03] this yellow
tinge to her face. Delicious. I don’t eat it. I love tumeric, I use it as a spice but not
because I’m trying to improve my health or wellness, or fight disease or cancer, or get
rid of the fungus, or any of that jazz that it’s been touted to fix. Just ’cause it’s colourful people like, oh
this can sell because it’s colourful. It’s yellow, so this Aseya this person was
on, so I had a bit of a research- Was it purple or something? No, no, it’s water. It’s properly oxidised free radical anti oxidant
ionised magic water. Yeah, but have you seen that other like water,
that’s like in [tounsel 00:11:41] and it’s like ones called like Love and one’s Hope,
or whatever. Is it glowing? No, it’s just normal water. But it’s infused with, like it goes through
pipes that have a different melody playing, infused with the right frequency- Diffused with hope. Yeah, something like that. I think it’s Hope, Love and something else,
but I was just like, what? Supposed he’s made just gazillions of dollars
based on just that. It’s like that alkaline water and things like
that. Oh yeah, same crap. But anyway, placebos amazing. Yeah, it does and fine, like if it’s not doing
them any harm, and they want to spend that ridiculous amount of money on it then- Go for it if you’ve got the cash. But if you’re going to ask my opinion, you’re
probably going to take it …