The addition (or subtraction!) of supplements, while on a healing diet like the Autoimmune Protocol is one of the hottest topics in our community. Personally, in my 6-plus-year healing journey, I’ve been through many “phases” of supplementation. At my sickest, when I was transitioning away from 10 years of veganism and dealing with extreme malnutrition due to a new diagnosis of celiac disease, I was taking over 30 supplements a day to help decrease inflammation, increase digestion, and get essential nutrients up to acceptable levels. Since then, I’ve gone all the way to the opposite end of the spectrum, adopting a more minimalist approach to supplementation.
My goal with my article is not to discourage you from taking supplements, but to consider them carefully in the context of your real food diet. I believe a lot of the long-term work to getting enough nutrients is always done first through the diet, and these are the reasons why.
- Real foods will always be the most affordable way to get nutrients. Think of what supplements are – concentrated extracts of compounds re-packaged into a product meant to be taken at a therapeutic dose. Depending on the nutrient, the process of making a supplement can be very resource-heavy – either using a lot of raw materials, a complex or labor-intensive process, or being excessively wasteful. By getting your nutrients from whole, real foods, you bypass this often expensive extraction and isolation process.
- Real foods contain co-factors that can compound effects, increase absorption, and increase bioavailability of nutrients. One common issue with supplements is that even if the isolated extracts are what our bodies need to thrive, often they are not as absorbable as the same quantity of that compound found in a whole food source. This is for a variety of reasons – sometimes there are other nutrients in a food that help with the absorption of the nutrient in question (for example, even though beets are a fair source of iron, their vitamin C content helps increase absorption). Sometimes real foods stimulate the digestive process that will mean better absorption of nutrients (for example, sardines are one of the rare food sources of vitamin D, which is more absorbable because of the natural fats contained in this cold-water fish). By getting your nutrients from whole, real foods, you get to take advantage of the increased absorption and compounded effects of these cofactors.
- Real foods may contain nutrients we haven’t identified or isolated yet. This, to me is one of the most compelling reasons to eat a wide variety of plant foods and not get too hung up on supplements. While we do know a lot about essential vitamins and minerals and how critical they are for optimal health, there is no way we can already know everything about them. By eating as much whole foods as possible, we get the benefits of these nutrients we haven’t even identified yet!
- Real foods contain often overlooked components essential to health that are often overlooked – like fiber, water, and phytochemicals. While most people are aware that many vitamins and minerals are essential to optimal function, these are included in the real food package. Fiber, especially that from a high vegetable intake, is absolutely essential to optimal health and promoting a thriving microbiome. Next, real foods, especially those brightly colored fruits and vegetables contain polyphenols, or a collection of over 8,000 compounds that have antioxidant properties. They have been shown to inhibit cancer, decrease the risk of both heart disease and diabetes, as well as boost the immune system. (If you want to read more about these topics, read the The Fiber Manifesto and Polyphenols: Magic Bullet or Hype? from Sarah Ballantyne).
- Real foods are less likely to contain fillers and unwanted ingredients, some of which could be allergenic, stimulating to the immune system, cross-contaminated with ingredients such as gluten, or just unnecessary to consume. Unfortunately it can be incredibly difficult (not to mention expensive!), to find supplement manufacturers that produce their products in an allergen-free facility and with the least harmful additives and fillers. If you are having a hard time finding affordable “clean” supplements, why not consider the cleanest source possible – the whole foods those nutrients are derived from! (To read more, check out Hidden Gluten, Grains, and Nightshades in Meds and Supplements).
Because of these reasons, I encourage you to start thinking about elevating the nutrient density and quality of the ingredients you use to cook your food, before you start thinking about supplementation. I believe this approach is not only the most cost-effective, but it is likely to improve your nutrition in more ways than one.
Wait… so when are supplements helpful?
My goal with this article is not to discourage you from using supplements. They can be a very powerful part of the healing process, and like I mentioned earlier, I’ve used them myself in my quest to get better. Here are some specific situations I’ve found supplementation particularly helpful:
- When a deficiency has been identified and targeted supplementation will be the quickest and most effective way to turn things around. This is common with nutrients like vitamin D and iron. Once the deficiency is corrected, underlying root causes to the deficiency should be ruled out and ideally you can rely on a healthy diet and lifestyle to provide you with that nutrient going forward.
- When digestion is not working properly and you either need supplemental support for the digestive process, or in combination with additional nutrients that are not being absorbed because of this dysfunction. An example of this might be a person with low stomach acid. Their absorption of minerals like calcium and iron are going to be very impacted by the lack of acidity in the stomach, both necessary for proper digestion. Support may be necessary to bring their acidity up to a normal level, as well as to give the body enough of those minerals to replace what they may not be digesting well. Once their digestion is up to snuff, it is unlikely they will need either support over the long-term.
- When the real food ingredients you are eating doesn’t have the nutrients you need. This isn’t common if you are eating a varied AIP diet, but if you are not eating certain foods (like red meat or organ meats, or seafood) you might consider supplementing with some of the nutrients you might not be getting enough of. Similarly, if you have been in the elimination phase for a long time and haven’t had luck with reintroductions, you might consider nutrients like K2 or vitamin E that are more plentiful in nuts/seeds, dairy, and egg products.
- Those in a deep healing phase working with a functional medicine practitioner to troubleshoot complex issues like inflammation, neurotransmitter balance, hormonal balance, dysbiosis, methylation dysfunction, adrenal fatigue, and other conditions. These treatments are usually short-term and aimed at restoring the body’s balance as underlying root causes are identified and eliminated, not long-term dependence or replacement.
I hope this article has helped clarify a sensible approach to promoting nutrient density first through the diet, and then through supplementation.
Do you have any experience transitioning some of your supplemented nutrients to real food additions?
Thank you for this great article. I just began my autoimmune healing journey with the help of a functional doctor. I’m overwhelmed ( and so is my budget 😉 ) with the amount of supplements I’m taking. Thankfully, I have a wonderful doctor that explained to me the what and why for each supplement and let me know which ones were short term, long term and how we were going to continue to decide what supplements will be needed.
This article gave me lots of food for thought for further discussion with my doctor to ensure that I take the least amount of supplements needed to heal and live a life full of health and wellness.
Hey Monnica! I’m so happy you found it helpful. It sounds like you found a great practitioner to collaborate with as they are keeping you informed of the whys and what you can expect as far as how long to take each one. Wishing you wellness!
This is great. I’m currently on a few supplements for liver support while I work on healing, and it is true that I don’t want to be on them forever, but for now it is a big help to my body.
Nicole – I definitely support targeted short-term supplementation for long-term healing! Hope you feel better soon.
What are the supplements that you recommend for low stomach acid? Txs!
Hi Amelie! Low stomach acid is actually a pretty tricky thing to supplement for as there are many contraindications. I recommend working with an AIP Certified Coach to figure out what might be best for you -> https://aipcertified.com/coach-directory
Thanks for the great article! Do you have a test wich supplements are good for your body?
I don’t have a test, but a working with an AIP Certified Coach to figure out what might be best for you -> https://aipcertified.com/coach-directory
I respect your expertise and have your cookbook which I use all the time. I wanted to let you know that for me I have to do medication and TPE-total plasma exchange and also supplements based on the medications I have to take. I don’t have Hashimotos, I have Myasthenia Gravis. I was not diagnosed until I was older but have had it for many years as I look back at my symptoms. I will more than likely have to supplement the rest of my life because of the TPE. The good with this is that with the treatment and the diet I do better than any of my Neurologist’s other patients. I told him it was from my diet, too. I am still able to walk and to work some. So I just wanted to put a different spin on things to you both. I will keep on the diet, learning and hopefully walking and working some!
Hey Cathy! We are not against supplements, especially if there is an extreme medical need like you are describing. I’m happy you found what works for you!
Great article, I think it is always good to periodically sit back and think about which supplements you really need to be taking and which ones bring you the most benefit. One way I determine this is I occasionally stop all of my supplements for 3 days and than reintroduce them again one by one. This helps me determine which ones are helping and if any may be causing some problems. Kind of an elimination diet but with your supplements. I have found this strategy to be very helpful for myself.
Madeline – I have done the same thing in the past, although I do it for a week or more sometimes. Great tip!