Expert Interview: Supplement Cycling
We get a lot of questions about supplements and herbal remedies. Midlife women are major consumers, using them to address a range of issues from menopause symptoms to concerns about brain health. We sat down with a leading lifestyle medicine experts, Dr. Hemalee Patel, to ask her about her theory of supplement cycling and why it’s important.
Lisa Health (LH): What is supplement cycling?
HP: In its simplest form, supplement cycling means not taking supplements every day. For most people, taking a break from supplements is beneficial to the body and your overall health.
LH: Where did this concept of supplement cycling originate?
HP: After several years in practice as an internal medicine physician with a specialization in lifestyle medicine, I’ve encountered hundreds of patients that have developed health issues as a result of taking too many supplements or the wrong kind of supplements. My observations have led me to develop a theory that you don’t necessarily need to take supplements every day. If you have a reasonably well-balanced diet, you should be able to obtain most of the nutrients you need from food sources. I always advise my patients to make changes in their diet before resorting to supplements unless there is a clear deficiency we’ve identified that supplements would help address. Even in those scenarios, there is often the opportunity to stop taking the supplements once the issue is resolved. There are also certain times of the year or situations when a supplement may not be necessary.
LH: Can you talk more about seasonality?
HP: Seasons play a significant role in determining whether you need a supplement. For example, in the summer, when you are exposed to more sunlight daily, you may not need to take a Vitamin D supplement. Conversely, during the winter months if you are prone to stress and a weakened immune system, it would benefit you to increase your Vitamin D intake as well as B-complex and Vitamin C to boost your immune system.
LH: What is your advice regarding supplements?
HP: First, exercise caution when buying supplements. Many companies make marketing claims about benefits that are not credible. Second, be wary of referrals from other people. No two people are alike, and you may not get the same benefits that your friend or relative gets from a supplement. Third, consult a physician before you start taking any supplements to find out if you even need the extra boost. As I mentioned, you may be getting all of your nutrients from a healthy diet already. The other benefit of consulting a physician is to find out the right supplements you need. Without consulting an expert, you may start taking the wrong one because you don’t know what your body needs. You can also deploy supplements selectively in times of stress or illness when your body is weaker, and many nutrients are not being absorbed. Lastly, some supplements can be very pure, but the concentration of the nutrient is so low that it’s not going to make an impact on your health. You would need to spend a significant amount of money to get the therapeutic dose and the benefit you need.
LH: What are the risks of taking supplements every day without a break?
HP: Not all supplements are water soluble, which means they need a longer period of time than 24 hours for the liver to absorb the nutrient. If you are taking a multi-vitamin every day, for example, you may build up toxins because the liver can’t handle the daily load.
LH: What kind of health issues have you seen because of over-supplementation?
HP: One example is a patient who was taking too much magnesium. She was feeling fatigued, had joint pain, and was experiencing headaches. She had already seen other specialists, including a rheumatologist, and they couldn’t figure out what was wrong. I noted in her chart that she was taking magnesium, so I asked her questions about how much she was taking. It turned out that she was taking a magnesium supplement, a multi-vitamin with magnesium, Vitamin D with magnesium, and magnesium baths. The patient is a competitive athlete and had heard that magnesium would help with muscle recovery. I recommended she immediately stop taking all her supplements and drink a lot of water. Within a week she was feeling better, and after three weeks all her issues went away.
Another patient came to me for a referral to a gastroenterologist because she was very bloated, had diarrhea and indigestion, and was breaking out in rashes. I asked her about supplement use, and she told me that she had read that probiotics are beneficial and was taking them twice a day even though her gut health was completely fine. She had small intestinal bacterial overgrowth (SIBO) from an overproduction of too much bacteria in her gut. When we stopped the probiotics and treated her for the SIBO, she completely recovered.
Another example I see frequently are women taking biotin to strengthen their hair and nails, and they end up having side effects. It would be best if you take a break from biotin. If you take too much, it could lead to joint pain and muscle aches.
LH: What are the benefits of supplement cycling?
You’ll give your body a break from trying to break down and process the supplements daily.
You’ll avoid toxic buildup and prevent the side effects of the toxic buildup that comes with getting more of a nutrient than you need.
Your stress hormones and thyroid will be more balanced because they won’t have to deal with the negative load on the body if you are overdoing it with supplements.
LH: Is there a specific method for supplement cycling?
HP: There is not a specific way to do it. For example, if patients insist on taking a multi-vitamin, I tell them to take it for a month, then take one every other day, and then for a week give your body a break. You can also alternate the days you take the multi-vitamin.
LH: Any other advice about supplements?
HP: Consult a physician to determine if you even need supplements at all. There are many interactions between supplements and medications taken for chronic diseases, and you want to make sure that they support each other and that you don’t have any adverse interactions.
Supplement safety is essential. You should find out where your supplements are sourced. Are they made in a lab, or are they sourced from an organic plant source? How are the capsules made? Artificial coloring and other unnatural substances can interfere with absorption. Some companies put extracts in to hide the taste, and you want to make sure those additives are safely sourced and tolerated.
For more information, check out our article on supplement safety.
Dr. Hemalee Patel, DO, is board certified in internal medicine and currently practices at One Medical, California Pacific Medical Center, Stanford University Hospital & Clinics, and Crossover Health-Facebook Headquarters. Known as a thought leader in the lifestyle medicine movement, Dr. Patel is a frequent speaker and advisor on topics related to empowering and educating individuals using the latest advances in health and wellness so they can prevent and control the development of chronic diseases and achieve balanced lifestyles. She received her BA in Economics and English from UC Berkeley with an emphasis in Preventative Medicine and Nutrition. She completed her medical degree at Touro University and residency at Santa Clara Valley Medical Center.