About This Episode
Welcome to Episode 012 of the PHW Podcast. In this episode, Dr. Davis sits down with Dr. Kristen Marvin to unpack the often misunderstood world of nutritional supplements. What exactly is a supplement? And why does quality matter more than most people think? Together, they explore everything from supplement quality and bioavailability to why store-bought brands may not deliver what they promise. Dr. Marvin and Dr. Davis walk through the science behind supplementation, highlight key differences between supplements and medications, and explain how modern food systems often leave critical nutritional gaps. You’ll hear patient stories, manufacturing insights, and real-world examples—including the risks of bargain hunting for your health. If you’ve ever wondered whether the multivitamin on your shelf is actually helping, this episode is full of practical tips, expert insights, and evidence-based guidance.
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Episode Transcript
Auto-generated from the episode audio — may contain minor transcription errors.
You know, I had another patient who they live out in the country and they have a septic system and so they're getting the septic system serviced and you know the guy comes out to service it and as he's leaving the guy the guy mentions to the husband, he goes, "Well, you guys sure like take vitamins, don't you?" And the husband goes, "Yeah, but how do you know that? How do you know that?" And he goes, "Oh, come over here." So he opens up the tank, shines a flashlight in there, and the husband was like, "There's just capsules float the tablets just floating on the top of their in their septic tank." And so he was like, I was I'm literally flushing money down the toilet. Down the toilet. Welcome to the PHW podcast.
Um, very excited to have Dr. Marvin back with us. My name is Dr. Jeffrey Davis and tonight, uh, it's episode 12. So, we're going to be talking about all things supplements.
Um, something that's, um, an important tool that we use in our practice. And, uh, yeah, I think it's going to be really interesting. We've been looking forward to having this conversation for a while. So, Dr. Marvin, thanks for joining us.
Thanks for having me back. Yeah, I think you were the host last time, so we get to switch uh places. Um, so this will be a fun conversation. Um, I mean, we use oftentimes we use supplements and medications interchangeably. So, what are some ways where you you try to frame maybe that supplements might be different from a medication? M you know the biggest differentiation for me is like supplements are typically supportive to the system right um you know even with like not just with frank nutritional deficiencies um but even how we will sometimes use certain herbal substances like ashwagandha has some pretty good research behind it and how it seems to help uh parts of our indocrine system like the adrenal glands and the thyroid gland work more optimally.
So it doesn't, you know, it doesn't turn them off. It doesn't technically turn them on totally. It might help with just their normal processes of like making hormones for example, right? Yeah.
So whereas like with a medication, you know, like thyroid is a great example here where it's like, okay, we could use, you know, in certain circumstances, uh, if a patient's thyroid, you know, labs come back showing that maybe those hormone levels aren't quite optimal and it matches with their symptoms. Of course, again, like after addressing all the lifestyle pieces, we might say, "Hey, here's an additional tool we can also use to try to help nourish and strengthen the gland so that those hormone the hormone production looks better, the the hormone conversion looks more efficient." Right. Whereas like with a medication, we're just giving the thyroid hormone. Right. Right.
So that in that place or in that example, you really are replacing function. And again to clarify for everybody listening, I'm not saying that's a bad thing. I'm just saying like that's a difference. It's a difference.
And sometimes both options are necessary. I mean, you know, you know, you're bringing up deficiencies. I mean, iodine deficiency has been described in like ancient literature. I mean, probably before they knew what iodine was. And so, and we know that there are parts of the United States where iodine is just not found in the groundwater.
They call it the iodine deficiency belt. and um you know there profound effects of iodine deficiency on the body. Now fortunately in the United States we have iodinated salt but I will say as people are moving to some of these fancier salts like you know the Redmond sea salt or the the Himalayan salts I sometimes wonder are we going to are we going to see some of that iodine deficiency creep back in that maybe we didn't are we going to see goiters start coming back because we're not doing the Morton's iodine assault because you know so what you know you you mentioned um the the research behind this and I often here. A lot of physicians will tell me, "Well, there's no research to support using supplements." Well, if they say that literally, then I'm sorry, you're just not like maybe searching the correct term on PubMed. Like, there is a lot of research. And I mean, now thousands and thousands of papers.
We can get into the weeds about, you know, what's considered good research and and that stuff is important. And I do think we should all continue to hold ourselves to a to a standard of sorts of like always wanting to be critically thinking through what we're reading and you know because we all have biases, right? Well, and I think we also have to be honest that the amount of money to put into researching whether vitamin C does XYZ is just not there compared to right what the pharmaceutical companies can spend on looking at what you know a statin does. Yeah. to your cholesterol, right? I mean, there's billions of dollars available for that research because there's billions of dollars to be made on those medications. So, right.
But I would also argue the fact that there are billions of dollars to be made on those medications means that research might not be as reliable because it's it's heavily influenced by the industry. Sure. Right. We've all seen studies where they've really massaged the data, done some pee hacking of the variables and and you know I mean even you know the editor former editor of the New England Journal of Medicine when she retired she said I don't think you can trust any research that's funded by the industry and it was like a mic drop moment in the community because people realized well all of the research is funded by the industry for the most part.
Mhm. Um, so yeah, I I do I hear that a lot and I think patients also echo it and feel that, but I I just challenge people especially with tools like chat GBT and Gro I mean you can do you can do a lot of research very quickly. Yeah. Or again, just hop on PubMed Pub. Yeah.
Type in with the new this new administration and NIH. They're making that information way more accessible for people. Way more accessible where we don't have to pay extra to access certain articles and stuff like that, especially stuff that our tax dollars already paid for. We already paid for like, hey, we technically already paid for this.
Um but yeah, no, there's absolutely research out there on a variety of, you know, quote unquote supplements or nutrients, but uh yeah, so that so that's that's probably somebody who just hasn't spent the time to look look and and I mean again like no blame to that person like there are not enough hours in the day or days in the week or weeks in the year etc to look at all the literature out there. Yeah. So, it's impossible to read everything, but at least, you know, I' I've learned enough to understand that before I go make a bold claim, I better go check quickly before I say there's an absolute on something. Yeah. To say there's no research.
I I now tell people I go, I haven't seen any research on that. I feel like that's at least gives me a little bit of a fudge factor because Yeah, you can just say, I haven't seen that to look into that. Well, some some other way. So, obviously, we use supplements to correct nutritional deficiencies. vitamin D like I gave with that patient earlier today is a great example, right? Um, you were talking about using it to support um, you know, someone who has maybe a low functioning thyroid.
What are some other conditions where you feel like supplements are just really helpful? helpful? Yeah. You know, in terms of like prevention, I mean, because again, sometimes maybe somebody doesn't have a deficiency, but they just want to make sure that they don't have that deficiency. So, might might we supplement from a preventative standpoint? Are there are there things that you know patients with chronic disease may need unique treatment options? You know even if people are on certain medications we have some uh tools we can use to check like does this certain medication actually deplete or like block the production of a certain nutrient in the body.
Um you know because there are certain types of like uh medications like methtoresate for example where patients have to take extra folate. You know unfortunately I don't know if we want to get too far into these types of weeds but you know, there are different forms of certain nutrients kind of like what we were talking about, I guess, with vitamin C a little bit where one form might be better utilized or more easily utilized in the body. So that, you know, of course always comes when we mention the word folate or methyl folate, you know, stuff like that. Absolutely.
I think you're talking about um whether something's bioavailable or not. Yeah. Like how bioavailable is it? Does your body even have to after it absorbs it, you know, take an extra step or sometimes several steps to actually get that nutrient into a form that can be utilized by your system. So, talk talk about folic acid because I think that's that for me is a was a big um something that I didn't fully understand was when you see something has has folate in it.
Often times a label will say say folate. has f it say it says folate, but then in parenthesis it almost always says at least part of it or sometimes all of it as folic acid. And again, I I you know, again, I've learned like don't just just because maybe you disagree with parts of something doesn't mean that it's ultimately bad. So, I'm not here to say that folic acid is like poison or something, but we have started to learn more and get more information that this specific form of this vitamin, it's technically vitamin B9, right? Uh folic, if it's listed as folic acid, that many people, probably upwards of at least 50 plus percent of people, Sure.
Yeah. have do have a MTHFR, which is a genetic, you know, variant uh in their system that just ultimately makes it that much harder for their body to utilize that form of the nutrient. But even maybe for people that don't, because remember, you know, ultimately with the majority of genetic variants in our system, it's not so much about the gene itself as much as it is the like epigenetic or the genetic expression in our environment. Right. Yeah. Yeah.
So, you know, I won't sit here and say, "Oh, folic acid's just terrible for everybody." But it's like, well, it might actually be pretty terrible for somebody who's not methylating very well to begin with because their environment's not great, you know. Yeah. So, so they would have to take that folic acid in their body then before it can be used as a co-actor in one of those many metabolic steps that we have in the human body, they would have to methylate it not once but four times in most cases to get it to a methyl tetrahydropholate state. Whereas if you took a supplement that had methyl tetrahydropholate and my understanding is so this is again what separates a lot of supplements from other supplements is you know if you if you were to go talk to a manufacturer and say okay I would like to custom make a supplement I want B9 they would ask you do you want B9 as Yeah. What form do you want as folic acid?
Okay well folic acid is going to cost you you know one penny. Yeah. Um and it be shelf stable for 20 years. Yeah. Or we can do methyl folate and it's going to cost you 15 cents per capsule and it's going to be stable for about a year. year. Yeah.
And so I I get it why, you know, so many supplements have folic acid in them because if you're just looking at the numbers, you're going to say, "Oh, this is shelf stable. We won't have to throw any lots away, right? And it's a lot less expensive." And and they and then back then they probably didn't know. I mean, you know, I think when you and I first started, there was there were no commercially available supplements that you could get outside of a physician's office that had methylolate in them.
And now, thankfully, I'm actually seeing more more and more more and more of those that are, you know, what I call the grocery store brands are actually they're they're cluing into that at some point. Yeah. I think because the public's demanding it, you know, they found that people are taking their dollars and going to another product that does have that form. But, you know, that's just one of many examples of some of the things we have to navigate with our patients, right? Where it's like they might be like, "Hey, I found this great product.
It's got, you know, whatever x number of nutrients in it." And that is a very common one. some of the B vitamins like B12 see a lot of cyanocobalamin versus like again a methylated form which ultimately you know to keep it simple we're just we're just saying there's evidence that shows that the overwhelming majority of people their body accepts this and utilizes this form much more efficiently. Right. Yeah. I I remember when I first started going to functional medicine conferences and I and I would go I was very excited because I'm like you know this biochemistry really brought me back to first two years in med school basic sciences which is something I was I've always loved just learning taking things apart and learning how they work.
So, it was kind of neat to think, oh man, I can go back in my practice and start utilizing some of these and I had very lackluster results and and I remember I'd, you know, go to the next conference and I would tell somebody I'm like, this doesn't seem to be working for my patients and they're like, "Well, what supplements are you using?" I'm like, "I don't know." I just tell them to go to Walgreens and get it. And it's exactly the same reaction they had. They were like, "No, you can't do that." and and then you know you start to learn like what separates something you know a a high quality um micronutrient from something that you might get at a grocery store and then so I think it's important for our patients I mean we spend a lot of time educating them and helping them understand I mean one of the simplest ones I tell people because they'll ask me they they'll bring in like well here's a screenshot of what I take what you think of it and so I try to teach them like well let's look at the label let me show you some some just real quick things that I look at to see if this is something that is high quality from even a manufacturing standpoint. So number one, does it have a lot number on the bottle? That's a real simple one.
If there's no lot number, there's no quality control, right? So you can automatically say this probably isn't manufactured in a GCMP facility, good manufacturing practice. Well, maybe we should go into like some of that. let's start like start with some of the basics like the foundation so that people can really understand because sometimes I find if I don't with patients in the clinic they're just kind of like yeah yeah I kind of hear what you're saying but I got I want to save money money right so but I think when we drive home that like you know one of the big ways that supplements and drugs are like regulated different right in the United States that's a great point so there's kind of like two main institutions that essentially because because right doctors will also say like well supplements aren't regul ulated. Well, they are, but they technically are regulated differently than pharmaceuticals. Well, so the FDA, uh, to be a drug, it has to, uh, treat a disease or prevent a disease.
And so, you you often see on supplements, there's a little phrase at the bottom. This isn't intended to diagnose, treat, or manage a disease. Yeah. Yep. Yeah. So, it's essentially like the FDA, the Food and Drug Administration, and then the FTC, the Federal Trade Commission. like those are kind of the two big groups that really technically like monitor supplements, right?
So essentially like the FDA is kind of there to make sure um that these essentially are safe, which I'll go into a little bit more because there are some differences there, too. But the FDA is kind of the part the party that's like, okay, is this supplement really what it says it is? So like, is there quality control? Like is it what it is on the label?
You know, those types of things. It's kind of a consumer protection role of the FDA, right? But one of the big differences it's uh supplements are categorized more as a food, right? And so with that, unlike a drug, these companies that make the supplements don't have to prove safety before it hits the market. Mhm.
Right. Whereas like with a drug, you can you have to do all that research and prove, right? Phase one, phase two, most teasing. We won't go into that.
Um but then the what the uh FTC does is make sure that like the marketing and the claims right are you know not misleading or like fraudulent right because a lot of stuff will get challenged and pulled because it's like claiming to be this miracle wonder drug. Oh this will make you lose all the weight or this will make you like never have dementia or something like that. You could actually argue that that is the separating line between something that's a supplement and a drug is a drug can make that claim because they can go back to an FDA approved trial that's gone through the trial process and they they were able to show in phase three. Yes. You know, phase one is basic safety, you know, and then but in phase three they're showing clinical efficacy for a claim and right and they have they have to have a study for every claim they say.
So that that might be the dividing line because there's actually some micronutrients we use that are prescriptions. Yeah, they are. I mean vitamin D is a great example. I mean that's available fish oils available. Technically vitamin C um even B12 um some of thamin another it's another B vitamin B1 some of these nutrients are technically recognized as drugs and even methylolate delin's a great example that is that is a vitamin.
Yep. Yep. Yeah. So yeah. So that's where like you threw out that term because this is another important thing to look for because you can find this on the label of supplements you're purchasing. Um the good manufacturing practices, right?
Or it'll say like the GMPs, I think, right? Um and so and there are like you can find them um I think they're actually on the FDA's website. It's a list of several things that the company making the product or the supplement has to essentially stand by to claim that they follow these practices. And and of course they're like arguably good practices, right?
It's all about like quality, purity, you know, tracing it back if there was a badge. Yeah. Yeah. So really like I promise you listeners that like when you and I are making a specific recommendation for a supplement, it is not because you and I want to make money, right? It's because I want to make sure you're not taking something that's going to hurt you.
Exactly. Or spending money on something that's not going to be effective. Right. Because Yeah.
There you're right. There is the spectrum of you know where a product has been you know somebody did some independent testing on it and this product didn't have all these vitamins and minerals it had a house plant in it right like literally a litally geranium yeah right instead of maybe like the herb or nutrient it claimed to be on the label which is frustrating because you go back and you go well PubMed said this particular herb helps with this particular condition in this subset of patients you take you're like it's working for me. And then well, they send those in. I think that study you're talking about, there's actually um 37 products that were pulled from four different stores. So, these are retail stores.
It was Walgreens, Walmart, uh CVS, and GNC, I believe. And in the herbal products, none of them had not one of them had any of the substances that it claimed to have. And it was some variant of a house plant. Yeah. From genetic testing, they they figured that out.
Hopefully in that type type of circumstance theoretically that's not usually going to cause significant harm for somebody. Sure. But then there are those examples unfortunately where it can where like contaminants can be found in some of these products that are you know they're being manufactured and made in countries like China where they have no problem putting toxic metals like lead and mercury in these supplements that you're ordering online because you want to save a dollar and meanwhile you end up with potentially like a heavy metal toxicity or worse some kind of endorgan damage or something like that. So yeah, you know, that's why we do in the office try we ultimately are very intentional about working with companies that oftentimes go above and beyond the good manufacturing practices. You know, for for the benefit of the listener, how do we determine which supplements are we going to bring inhouse that we're going to be using? We we go through a long multi-step process of figuring that out.
But what are some things that we do that you know can maybe give the patient reassurance that okay this is a high quality micronutrient. Yeah. Yeah. Well we definitely only work with companies that are at least going to follow that minimum baseline of those.
So they're all GMP certified. They're all GMP certified. Some of them have additional certifications like NSF is another certifying body. Right. Exactly.
IOS is another like fish oil certifying body. But I think another important indicator along those lines, uh, the companies we work with will do independent third-party quality testing, right? And what does that mean when you say independent third party? Third party.
So the the first two um parties are going to be obviously the company, right, that's making it. Sure. So let's say like um a Nordic Naturals. It's a good example of a grocery store brand. Well, and I should clarify when I say the the company that's making it, I I kind of meant in that moment like the company that's actually putting the supplement together, like manufacturing the actual product that like we sell, right?
But then the other party in that is the company that provides like the raw nutrient. nutrient. Sure. For the company X that we purchase the finished product from. So those are so those are like your first two parties. Like a multivitamin is a great example.
Um, you know, you we we get a multivitamin, let's say from a company like Zyogen. Yeah. They they're going to have to source the vitamin D, the vitamin C, the selenium that's in there, all those things that those raw materials are going to come from Germany. They in the case of like a lot of minerals come from Germany. Germany's highly recognized as they're like Albon is a great example. Very high quality minerals.
Yeah. But then there's a lot of stuff that those companies they have to go to China. China's the only source of these raw materials. I mean, they've they've outpaced our manufacturing, unfortunately.
Right. Yeah. And so, third company involved. Yes. That's where the third party comes in because you're essentially, you know, as much as you can say we're not biased.
We just want what's best for everybody. Like you're always going to have some bias towards like your thing, right? So, the third party comes in to say we have no connection with party one who's making the actual product. We have no connection with party two who's supplying the raw materials.
So we're literally an independent, you know, clearminded like we have no skin in the game here. So we're going to tell you the truth no matter what, right? And these are labs to pen labs that do like spectraphic analysis. So we'll do very detailed analysis to essentially ensure what the you know these other parties say is is right. Like so if we're saying, "Hey, this is the purest, cleanest form of magnesium glycinate," then that independent third party is going to say, "Yep, you're telling the truth." Or, "Well, this you think it is, but we actually found that this batch is contaminated with lead." Or, you know, or or it's just not magnesium at all.
Well, I think like Natural Column ran into that problem with one of their products. they they weren't doing thirdparty certificate or analysis and then somebody took natural column and then said well I'll pay to get it analyzed and they found I can't remember what it was it was a certain amount of heavy metal and you know I think the company addressed it but yeah I mean that that's I think not only you want to make sure that it has what it says it has but also in the amounts that it says it has right so I mean and I know for certification for fish oil like you you cannot be you have to be over what you So, if you say it has this much EPA, one of the omega-3s, it has to be has to be at least that or more. Yeah. It can't be just slightly below. Yeah. And and what a lot of people don't know is for generic drugs, they don't have to be exactly.
They can be what? 20% off the mark. And and so, you know, for something that's dosed very precisely like thyroid, that could be the difference between two different doses. Yeah. Um Okay. So, we've got third clarify that. Yeah.
Yeah. So, like that. So, everything in our office Yes, we we could look at the lot number and call the company and say give us the the the certificate of analysis on this lot and we have had times remember in the clinic where we are on back order of something because the company's like hey our uh this raw material for this product that you guys like it did not pass the quality right you know yeah that happened a couple times with some of our custom manufacturing what blew me away so I took a tour of one of these facilities years ago in Florida And they they had a whole section of their manufacturing facility that was they where they quarantine quarantine the raw material. So a 55gallon drums of vitamin D powder would come in.
I mean it's a massive amount of vitamin D powder and that would be in a locked off section of their uh manufacturing facility separate from everything else. And they they were selling out sending out aloquats of that for testing. And and at the time it they said and I can't remember it was hundreds of thousands of dollars of material that they would have to return. Yeah. You know, in some cases they're returning it to China saying this we can't accept this.
It didn't it failed our testing. Yeah. And and I asked them at the time I go what is what does China do with that? Do they dispose of it?
And they said no no no. They turn around and sell it to somebody else. Yeah. Who doesn't do that third party? Because the the reality is not only is that time inensive for that company, it means it may send them back in their manufacturing process because there's supply issues involved with sending raw materials back, right?
Um but they are having to pay to have that testing done, right? And it's not obviously it's not required by the FDA. Um and and I would argue I mean if people think prescription drugs are so much better, go read Katherine Ebon's book, Bottle of Lies. Yeah. fantastic book talking about the generic drug industry and how there's almost zero oversight. Those places almost never get audited, right?
And and there's I mean there was something like one inspector for every thousand drugs that's that's produced. Yeah. And so they just they just know it's a numbers game. Yeah. Yeah. No one no one's ever going to check our work on this.
So So that that third party certificate analysis that is something that increases the cost of supplements, would you say? Absolutely. Yeah. Absolutely.
Yeah. But that helps us know keeps it safe. We know we're not getting you know what you're getting mold in there. They're checking for, you know, microcontamination like bacteria. They're checking for heavy metals.
You're getting an arguably like therapeutic dose of what you really need for something. So, cuz like you kind of referenced earlier, how frustrating is it where you're like taking this product, you're thinking you're supposed to get some result from it and you don't and it's not. It's because it's not what it says it is. Well, I think you know I think you remember the the whole green lipped muscle oil that was really popular back then.
People were like, "Oh, this is a really high quality fish oil." And you know, we would we would test omega-3s in the blood and we'd be like, "Man, omega-3s are really low." "Oh, no, no. I take this stuff. They say it's the best ever." And then it was like a year later it came out that they did a genetic analysis and they're like, "Whatever. This isn't from a green lipped muscle or wherever they say it's from." Yeah. And so, you know, again, I think there there's a lot of people in the industry that are trying to pull the wool over people's eyes.
It's a difficult industry to be in because maybe of the lack of rec, you know, of oversight. Yeah. But I would say it goes back to everything. Buyer beware. Be a sophisticated buyer of supplements.
Right. Right. So what are some of the things that you tell patients to look for when they're looking at supplements to see does the label look like it's a high quality supplement? Yeah. I mean the bioavailability is probably the most difficult thing for regular patients, right? Yeah.
Especially with the like we were kind of referencing earlier with different forms of certain nutrients, right? Where it's like there's several forms of vitamin B9 or like magnesium is another great example. Yeah, several forms of magnesium. So that that for me is a litmus test.
Another litmus test is someone brings me a label and I look around go let's just look at it. So we look and we go okay folate as folic acid that's ding number one not a great bioavailable form. Magnesium as magnesium oxide usually right so what is the mag magnesium oxides 4% bioavailable. Yeah, I always tell people unless you're trying to treat constipation maybe great for great for loosening the bowels probably not getting significant levels into the body. So, you know, I think you mentioned cyanocobalamine versus methylcobalamine.
So, those are some kind of easy things that people can do really quickly just to look and then dyes like Yeah. Remember when we tried to find a prenatal? We we had a patient who was allergic to some like red food coloring I think it was. Yeah.
And um it used to be very difficult to find. Well, yeah. She said she said, "I need to find a prenatal vitamin that doesn't have that isn't pink." Yeah. And and so we called the pharmacist and we're like, "Hey, do you guys have a multivitamin that we can order that doesn't have any dye in it?" And the pharmacist was like, "Oh yeah, I'm sure we can." And she I'll call you back. And we got a call at the end of the day.
And this pharmacist, poor girl, she's like, "I'm pulling my hair out. There's nothing out there." They go, "Why are they putting shellac in this stuff?" I mean, she like it was like the curtains were pulled back for her and she was like, there's all this crap. Yeah. So, forms and that's a that's that's usually a really big ding for me is when I see these supplements that have like artificial colors in them and it's like why? It doesn't need that at all.
Who cares what color your capsule is? Yeah. Or just like, you know, there's a ton of like polyethylene glycol and just, you know, some of these ingredients that So, that's another thing you can look at. It's kind of like with food, right? like when you're looking at a label, keep it as simple as possible. Um, some things, you know, are difficult to totally avoid and and arguably for most patients, I think, are pretty inert. You know, I sometimes get a bunch of questions about like magnesium steroid, you know.
Yeah, that's a tough one. It's a tough one because I I do believe that some people maybe really notice a reaction to that. But for a lot of even our high-end very reliable good supplement companies, um that's hard to avoid because it's really the machinery that needs that substance. So that's a flowing agent.
So yeah. So sometimes I try to, you know, again, if I'm like, hey, if if this really if you really think it's this thing, okay, let's try something else. Because there are a few companies out there, um, you know, like pure encapsulations and stuff like that or, um, or even like there's some custom, you know, uh, formulating companies where they'll make stuff for you and they can really keep as many additives out as possible like just a vegetable cellulose capsule for example. Well, and that brings up a great form like so so not only the form of the micronutrients, maybe the the bioavailability, the the dose, right? I mean, how much is in there?
Um, for me, the the form, so tablet versus capsule, you know, I I still have this image that I took. I was doing a colonoscopy years ago and I get to the seeum, which is sort of when you're done with the colonoscopy. I've gone, you know, rectum all the way around, you know, transverse colon down into the seeum and there's two one a day vitamin tablets that I can still read one a day stamped into it. Oh my god.
And I I still I have that picture somewhere on my iPad. Yeah. And um Yeah. You know, I had another patient who they live out in the country and they have a septic system and so they're getting the septic system serviced and you know, the guy comes out to service it and as he's leaving the guy the guy mentions to the husband, he goes, "Well, you guys sure like to take vitamins, don't you?" And the husband goes, "Yeah, but how do you know that? How do you know that?" And he goes, "Oh, come over here." So, he opens up the tank, shines a flashlight in there.
And the husband was like, there's just capsules float the tablets just floating on the top of their in their septic tank. And so he was like I was I'm literally flushing money down the toilet down the toilet. And so you know t so that's another thing I learned in the manufacturing process is tablets are very very inexpensive to produce because a tableting machine can just pack powder and then you know then they okay then people are like well it's hard to swallow. Oh no problem we'll just we'll put shellac on it. Yeah.
Yeah. So I will say there are some tablets I mean we even carry in the office a couple of tablets but it doesn't Yeah. They're specially designed. Oftentimes it's because we needed like something in the form of like a time release. Well, nice is a great example. Like if we're going to use nyin, we want it to release slowly.
In fact, I'd be happy if a little bit of a nice tablet was left by the time it got the colon because putting something on really high immediate release nin makes them feeling side effects and things like that. But um yeah, ultimately like you won't see shellac listed. Like you literally will see shellac listed or it's a tablet that's meant to dissolve in your mouth or it's a tablet that you chew. I think those are exposed.
So, I'm not saying like all tablets are bad, but Yep. But it was shocking to see. Yeah. Like you shouldn't see your tablet coming out in your stool. Yeah.
So, I mean, and and one of the things that I I remember on that that third party certificate analysis, one of the things they analyze is dissolution time. So, they're actually looking to see in the pH of the stomach, how long does it take the capsule to break apart? And in, you know, with those veggie capsules, you were saying in most cases, those reports I've seen, it's six or seven minutes. So in six minutes it's dissolved and absorbing into your body.
So yeah. Yep. Yep. So a lot of work goes in to make sure that's what we want for our patients. It's like you know we're we're not we're not trying to say oh you got to only use ours and I you know I always tell people I'm like we we are not married to any product.
No. In fact we we cycle products in and out based on and we find something that works a little better. We get better results with. We get together at least once a year if not twice a year with the whole provider team and hash through the list of what we're carrying and we're really intentional about it. So I think that's the big ones.
Those are the big ones. Yeah. So again to summarize I would say it's bioavailability, right form, right dose, right? Um you know that that it's something that truly is best taken in a supplement form. I mean again I remember there was years ago I think the same company that did the the green lip muscle they were doing butter oil capsules. Do you remember those?
Yes. That was literally butter jammed into a capsule. I'm like, "Hey, I don't know if you've tried butter before, but it's delicious. It's just eat butter." And don't, you know, I mean, we're not trying we're not, this isn't like, you know, grandma and grandpa telling you some story that nobody that's like never happened or like happened to so and so's twice removed third cousin's wife or whatever.
Like I I've had patients Yeah. who thank God weren't harmed but that were contacted um sometime and like one I'm thinking of in particular was contacted by Amazon because really yeah so I mean that kind of brings up another like no I mean I I if I'm being totally honest I have like a lovehate relationship with Amazon right it's like oh so convenient sometimes so convenient you want something you pull your phone up but like I think I think Amazon's one of the worst places you can buy supplements for several reasons and we I I I share this with my patients. We can share it now if you want. Sure. But yeah, I think it's very important to learn because I think Amazon again largest retailer on the planet. Yeah.
Lots of people shop on Amazon the same way you and I do. But why not supplements off of Amazon? Yes. There's a handful of reasons.
Um one, you know, obviously, you know, any I mean pretty much anybody can sell on Amazon. Yeah. Right. So lots of third, fourth, fifth, sixth party sellers, right? where it's like they can just buy, you know, bulk or and then, you know, modify the product to cheapen it or stretch it out or whatever. Or sometimes they just steal labels and marketing and slap it on a fake product and well, and this happened to me actually.
I I was at a conference years ago um and I left my magnesium at home. Like I really magnesium helps me sleep, especially when I'm away from home. And um I was in a city where Amazon same day delivery was available. Remember when same day was like a big deal? It wasn't like it was available in Dallas in a few markets.
And I was like, "Oh, I'm going to try this. I'll bring it to the hotel. I'll have it in a couple hours." So, um I ordered a magnesium and and when I got it, I opened the the bottle and I was like, "This doesn't look like the magnesium capsule I have at home. I wonder if I wonder if they've changed." Well, I have the rep's phone number for our product on my phone. So, I snapped a picture of it and sent him a text and I was like, "Hey, did you guys change magnesium?" He goes, "That's not our magnesium." And then I showed him the bottle. He goes, "That that looks like our bottle, but that is not our magnesium." And I was like, "Wow, they're very sophisticated." I mean, and this is one of those bottles that even had like an embossed edge to it.
I mean, the lab the label. It was a good fake. It was a good fake. Yeah.
And so, and you get it like some of these and a hard part I think for these businesses that do go a step above, right, that that are known for the high quality third party certificate. Once you're known for that, well, now you're a mark, right? People recognize that brand and go, "Oh, I know that's a third party high quality brand. I've seen that at my doctor's office. I can get it on Amazon.
Oh, it's 25% off. Well, that's great. There's a sale on it." No way to know if that's the actual product, right? Yeah.
It's also hard, you know, Amazon obviously has warehouses, you know, all over the place, but you know, the question of like, is it temperature controlled? Like, is it, you know, how's the humidity? Is your product seeing a bunch of heat or light or moisture, you know, right? It's like 60 ft up in an Amazon warehouse in on July that's like not not controlled, right? I mean, be 150° up there.
Yeah. Yeah. So that can obviously I mean most times it's not necessarily going to like make the product poisonous but I mean it'll affect the quality reduce usually the you know efficacy of it. So um but yeah I think the biggest one is my my biggest concern is that you're going to get a fraudulent product and who knows what's in it. though, you know, this happened to a patient of mine and thank God it didn't seem to be anything that like harmed her, but I mean wasn't what it said it was and you know and and it really it really to go back to kind of the regulation piece, it's like you know the FDA does what it can but like it's just like even with drugs, they can't they can't monitor every single little thing. So they with supplements they really do rely pretty heavily on the public reporting a concern and then they go investigate it and find out and you know so so again it's it's your health is not worth a shortcut or a discount you know um uh and again we I do I still will work with people to try to find highquality products that work with their budget ultimately in the end.
Yeah. And and we try we try to obviously do that too in our clinic, right? We we uh you know have good relationships with these companies. We buy a lot of our product in a large quantity which helps us bring down the cost. So you know we're trying to we're trying to be really mindful of that with patients too. I think anyways yeah and and I think the other thing that that I like is that when we have found you know we obviously put our label on a lot of things and you know when we started that private labeling it it wasn't about trying to obscure where the product was come from.
We we'll tell anybody all the time who's the manufacturer. We're happy to tell them. I care. Yeah.
It's this product. But it's really about letting our patients know this is something that we we use enough and have seen the clinical efficacy. And like you said, we you know, we've done the review and we feel confident in the product, confident enough that we're we're ready to put our name on it, right? And I think that's, you know, again, another thing that says we stand by it, we trust it. Yeah.
Um Um absolutely. Which for me is really important. Yep. So, you know, I think everybody wants to know, you know, you get get these guys like, "What's your stack?
What do you what what supplements should I take? Know what I'm taking?" Well, you get, you know, patients come in and they're like, "I want you to look at my supplements and tell me if I'm taking the right stuff." I'm like, "I don't know. I mean, I kind of have my four favorite that I sort of stay on all the time." So, I'm curious what what's what's Dr. Marvin's like what's in your supplement repertoire? I mean not you know now again I'm not saying for treating an illness or disease or anything going on with your health just like what's your basic like what you would say without knowing anything about the patient adult female what's a good thing for them to take well you know I'll I'll clarify if I need to but I mean like for me personally especially like I'm a mag like you were saying I'm a magnesium junkie.
Yeah. Like if somebody said you got to go live on a on a deserted island and you can only take one supplement what are you taking? magnesium. Definitely taking magnesium for sure. It just does so many wonderful things in the body. It affects hundreds and hundreds of different enzyatic pathways.
But for women especially, I mean, it goes all the way from supporting the nervous system and helping with sleep all the way to your gut and your liver and metabolizing hormones like estrogen. I mean, it really is an amazing nutrient. So, are you using I take a ton of magnesium. So, not magnesium oxide. No, definitely not that. Uh, what's your favorite?
My favorite form is magnesium glycinate. The glycine, it's the amino acid glycine. And again, it's just such a calming like good amino acid for the nervous system and it's pretty gentle on the gut so most people can tolerate those higher doses that a lot of people arguably really need without it causing like loose stools or that type of thing. Yeah.
So, that's my favorite. But yeah, mine I think would be the the the glycine the glycinate malate combo just because the malate's a little more supportive for the muscles. So yeah, hard workout, you know, you're you're getting some especially, you know, when Kirk's got me in a neuro program. You're like need need to like bathe in magnesium. Yeah, exactly.
Okay, so you got magnesium. Definitely magnesium 100% all the way. Um I would say well I mean gosh my brain was like I was like oh I'll tell you what I'm taking. But if I like have to think generally, I mean people really can overall benefit from like a high quality multivitamin just because like our conversation earlier as as much as and you and I, you know, living the way we do and where we live and trying to grow our own food and stuff like that.
I mean, but ultimately at the end of the day, the soils depleted, things are different. Um, and sometimes just our modern day of living, our demands are higher too, right? It's kind of a combination of those things. So, I do I do think uh you know sometimes I kind of view it as like a little bit of a good insurance policy of sorts where it's like at the end of the day I'm still prioritizing food. Like I definitely don't cheat my diet thinking, "Oh, it'll be fine because I take a multi, right?" I essentially take the multi to be like I really did the best I could with my diet.
I'm just kind of like shoring up a few things here. You know what I mean? For me, it's like uh filling in the cracks and the bricks, right? little little grout around the edges just to make sure there's a couple days I didn't eat well or maybe I was stressed out. At least I've got the multivitamin covering that. So, I think that's uncontroversial.
You know, it's like as much as I would love to just naturally get my vitamin D 100% of the time. Um, you know, first of all, I don't live in a place where I could arguably do that year round. And so I do think vitamin D is definitely another one of those supplements that just because of all the benefits, anything from your immune system to your brain to your bones, you know, and I guess with vitamin D, we should add in the other vitamin K, you know, in the form of K2 because there are it's K1 and K2. Um or sometimes it's MK7 or meone. Yes. Exactly.
And so I think, you know, those two kind of go together essentially. Um, so let's see. I mean, I I also personally, I'd say those are like the main nutrients that I take. I do, you know, a couple times a week take a big old swig of cod liver oil.
Um, I try to eat fish, but again, you know, where we live in Kansas, we're landlocked. We don't get the best like fresh fish availability, right? So, still try to eat fish a couple times a week, but I find that if I top it off with a little cod liver oil supplementation, my omega levels are amazing. Yeah. And don't even have to technically supplement every day.
And cod liver would be really important for a growing child. It's a little higher in the DHA than the EPA or or breastfeeding mom. Sure. Cod would be good.
Yep. Yep. And again, you know, there's obviously several different forms I think of good fish oil or omega-3 supplementation. I just personally like the cod liver. I just, you know, to it helps cut back on like capsule count, you know, it's just a liquid.
Yeah. Um, so that's kind of another, you know, I mean, I'm kind of keeping it more nutrient-based, but I personally also take um adaptogens. You know, I'm a working mom. I've got a farm and kids and, you know, all the things. A husband.
Oh, yeah. Husband, too. We just had our 15th wedding anniversary yesterday. Oh, happy anniversary. But yeah, so adaptogens, you know, those are typically uh I I prefer I use ashwagandha um just to help support just those general stress responses. And I feel like, you know, overall it just kind of helps me feel a little more resilient, helps with sleep, you know, these are all things it's even documented showing beneficial for.
But we use that term adaptogen. I don't think we've really defined. Yeah. Yeah.
Yeah. I mean, essentially what it means is that it like helps those systems in your body adapt to stress. Way I've heard it described is specifically when it comes to cortisol, it's almost like a buffer. You know, you think in a scientific equation kind of helps you like get that what we would expect just physiologically, right? Too acidic, a buffer will bring you down.
If you're too basic, a buffer will bring you up. Yeah. Probably those adaptions work similar. Yep.
Yep. And then I take a little bit of vitamin C. Not all the time, every day, but sometimes I have seasons where I'm just like feel like I'm run down, need a little more immune support, still help support the adrenals, you know, stuff like that. So, kids are getting sick. Yeah, kids might be exposed to stuff.
Staff are dropping right and left around you. You're going to hit that zinc a little harder. Give me I'm like shoot it straight in, you know. Yeah. Yeah.
Um, and then, oh, you know, another one that we carry I really like, I mean, this is more from like kind of more of female hormone perspective is estrotect. It's essentially a concentrated DIM, which stands for dandelane. Um, really helps the liver metabolize estrogen. And, you know, despite it's like I have pretty healthy diet, you know, I'm eating foods that help do that. uh you know there's just things in the environment that we get exposed to that we don't have a lot of control over that are endocrine disruptors stuff like that. So you know those types of things are really helpful. Yeah.
I don't know what about you like what are your daily like goto? I I kind of kind of talk about the big three which would be multivitamin um D3 and fish oil. Yeah. Those are kind of my big three that I take and I would say I've now changed that to the big four.
Creatine. Creatine. Yeah. Creatine. I don't know.
I mean, I've really feel like it's more than just hype. Like that that double dose of creatine. creatine. Yeah. I've noticed that's helped with just mental clarity, word finding.
Yep. I mean, there there is obviously the benefit in the gym with lifting. You find that you hydrate the muscle a little bit better. Yep. Hydrated muscle is going to be a bigger lever, bigger levels, you're going to move more weight, but but the brain benefit of creatine's been surprising.
Good. Yeah. Been really good. So, that's those are kind of my four that I feel like I take all the time. And then I'm like you.
Zinc, vitamin C. I have those on standby. And then, you know, I've got some uh things I'm trying to push around with my lipid panels. So, I take NAC. Um try to get my LP little A down. Um I'm taking additional CoQ10.
Even though my CoQ10 level is pretty normal, I just feel like that's one of those that's just a great antioxidant. Yeah. Yeah, for sure. Have you chewed any Nasin lately?
No. Yeah, I did that once and uh man, I thought, what in the world is going on? I'm like, you look sunburnt. Yeah, I think I remember that. Like, did you hit the tanning bed this morning?
Well, I think I was I had like a DGL chewable and then I had the nyin which is supposed to be slow release. Yeah. You got your tablets mixed up? Yeah.
I swallowed the DTL chewable and chewed the nice. I remember chewing it thinking this one feels like stale. Like it just was a little bit too chewy. And I walked into the office and it it hit and I was just people were looking at me like what is wrong with you? I mean I'm just bright red from head to toe.
Oh you know one of my favorite that thankfully I don't have to use too often but it's just oh I just I love it. you know, it maybe would just be up there with like it's nice to have in a pinch. Yeah. Is uh the the oregano oil that we're carrying. You love oregano. I love that because, you know, when you just need something for, you know, maybe a and I'm not talking like your leg is rotting and falling off your body.
I'm not talking about like even I'm not even talking about like, you know, maybe a UTI that can obviously develop into like a full-blown kidney infection, okay? I'm not talking about like life-threatening infections here, but for like a little sore throat. Yeah. But I mean, yeah, like viral or even like acute sinocitis that's not complicated. I mean, I have seen that clear things up in days, like a few days. So, you're using it as an antimicrobial.
I'm using it as a general antimicrobial. And of course, you know, I use it for a number of like just chronic complex gut conditions and stuff like that. But I will tell you, like a few years back, my husband had a just acute sinus infection. And thankfully he doesn't, you know, it's not like he deals with chronic allergies or anything like that.
But I mean, he was blowing out blood. Like it was getting a little serious. Pretty bad. Probably because he didn't start like some of the support when I told him to, but we'll let we'll leave that part, you know, off a man that doesn't listen to what his wife says. Shocker.
Um, but I did I just look fin got when he's like blowing out blood in the in the tissue, he's like, "Okay, what do you want me to take?" And I'm like, "You got to hammer some oregano or you got to maybe do an antibiotic." and he's like, "Well, I don't really want to do an antibiotic." So, um, hammered some oregano, 36 hours later, it's totally gone. Well, and what's great about that approach is, you know, again, people aren't dying from sinusitis. Yes, it can get complicated and can get serious, but it's very rare, right? And and so, you know, if the oregano doesn't work, all right, you got to get on some emoxicyl maybe.
But, but if oregano does work now, you haven't blown out your your biome, you know, and what's going on. something we could probably make a decent argument for too is that you know trying to be more proactive and supplements sometimes can help you do that to a certain extent right before something becomes a bigger problem. Yeah. Like sometimes with the when we're you know taught to use antibiotics we tell people we'll wait until it really gets to the point where we know that it's bacterial. Whereas with oregano, you could say, I mean, the first sign of your sinus headache, take a little oregano, right? Along with, you know, there's lots of other good immune supportive tools that we use to where and you know, sometimes it's like the argument isn't that you're just trying to do something naturally.
It's like a lot of this stuff arguably when done appropriately, ideally under the guide of somebody like you and me, sure, you know, is I think arguably lower risk in a lot of cases, too. Well, yeah. How many overdoses are there on vitamins in the United States per year? Yeah. I mean, you know, and if it's probably if it's anything, it's coming from a crappy children's chewable because it tasted, you know, the good.
Yeah. It was like too many iron or something like that. Right. Right. Right. Yeah.
So, almost none. Almost none. Yeah. I mean, we can be very confident that we're not going to overdose something on this, but Yeah.
Yeah. But you know and and even you know like vitamin D maybe that's another good example right of like yes there are some fats soluble nutrients that you need to be mindful of but don't you think I I don't know I think vitamin D changed for me when when I had that you know patient very early in our practice I was afraid that I was going to be known as a guy that killed somebody with vitamin D and I've told the story many times but there's a patient who took a liquid vitamin D which is a thousand IUs per drop per drop not dropper. Yeah. So so we're talking normal dose would be five drops a day. Yeah.
Um, and she just decided she was going to drink the whole bottle. And it's like what, 150,000 drops in there. I don't even know how much, but lot of vitamin D. A lot of vitamin D.
And I and I, you know, came in and we checked her level and it was like something like 300. Yeah. Yeah. But like calcium was totally normal. Parathyroid hormone with calcium.
We checked all electrolytes. I asked her how does she feel? She goes, I had a little headache yesterday, but I feel fine today. And so I'm like, okay. So there's no sign of toxicity.
You know, nausea, vomiting, headache. Those are signs of toxicity. no signs of toxicity. I told her, "Okay, don't take any more vitamin D." Almost felt like telling her, "Don't go out in the sun." You know, I didn't know. know. Yeah. And so, we just watched her vitamin D slowly fall back over time. And what was remarkable is I remember she had Hashimoto's.
And again, I'm saying this disclaimer, this is not a way I would treat Hashimoto. Yeah. It was not like a treatment, but but like the next time we checked her antibodies, they were lower. Now, did the vitamin D do it?
I don't know. Well, there's that's the thing though, like when if we want to reference back to like there's there's studies that show that like some of those nutrients like vitamin D, they definitely help with the immune system. system. Yes. So, I I've wondered, okay, we call it a fat soluble, you know, micronutrient that we think you can get toxic, but even vitamin A, I mean, you and I have used massive doses of vitamin A and ever seen. So, I wondered, do we need to reframe vitamin D as a not a vitamin H hormone D?
Oh, totally. Right. Because what the definition of a hormone is something that's made in one tissue and used in another. Well, we make vitamin D in our skin and use it all over our body.
So, I feel like I feel like that one probably shouldn't even be considered a vitamin necessarily because vitamin technically is something you can't manufacture on your own. We make vitamin D. Yeah. Right. So, yeah.
Yeah. So, I think it's just a good reminder where it's like, okay, we we um probably don't need to have like some unhealthy level of fear here with some of this stuff, but but you do need to have a good understanding. And again, ideally, it's it's helpful and arguably safer to a certain extent to have somebody like you and me be able to give feedback and guidance on dosing and, you know, how you want to use something, how long you want to use something, and make sure you're not covering up something else ultimately, right? I also tell patients, you know, the ones that are somewhat skeptical about using supplements, I tell them, you know, mo most drugs that we use today, we're based off of plant derivatives. Yeah.
I mean, yeah, statins are a great example. Statins are a great example and and you know, we use red yeast rice in our practice to help people lower cholesterol. Well, red yeast rice is a natural HMD COA reductase. So, um and can be very effective in in lowering cholesterol. Um yeah, I mean there's so you know I think of the the things we have some things that we use commonly like you know someone with acute diarrhea we found that using highdose probiotics is super helpful sometimes. So women women who are having problems I mean one of the probably the supplement that we see used the most is our fem balance um that product um has been amazing for people who are parmenopausal post-menopausal on hormones whether you're on birth control whether you're having dismenoria you know painful periods to to the point where we we had when we first had that product we we had that manufacturing problem um couldn't get it we had we had women who were in tears because We ran out of it.
And I've never had anybody cry when we run out of fish oil. Yeah. Nobody cries when we run out of vitamin D. But we had husbands that would come in and say, "I need to buy this by the case cuz I don't want my I don't want my wife and three daughters to ever run out of fem balance." So, I mean, I think there's there's been some products that we've found would be really tough to do what we do on a daily basis without them, right?
They're tools that I think we find very helpful. Yeah. Yeah. Um Yeah, for sure. But yeah, I think there's a lot of nuance in that.
If I was just going to say anything about a supplement is that, you know, it's it's shouldn't really be the first go-to for a lot of things. And it's definitely not a fixall for everything, right? It's like it really is just a tool, an option as a tool to support. Sure.
It's a piece of the puzzle, something that maybe you're trying to optimize or help or whatever, you know. Yeah. But it's it's I really try and I think as a clinic and as a team we try really hard not to just be you know like I said earlier that term green alopathy right you know or just pill for problem but we're just using supplements and and I encourage patients to you know because again understandably people come in with that expectation they're just like you know as an easy example would be like I have high blood pressure and I don't want to take high blood pressure medication. Yeah. What's a natural alternative?
I'm like, well, here's why it's not always good to like think of it that way, you know, because ultimately you want to try to look at a problem, figure out why it's a problem. Yeah. Are they overweight? Are they do they have sleep apnea? But but you know, once you've gone through those things, I mean, for me, blood pressure at least, one of the big ones I use is well, magnesium.
I mean, going back to smooth muscle relaxing. Yeah. Like that can be part of your process of figuring out the problem. I mean, is it is is part of the problem because you're lacking a certain nutrient. Yeah. You know, it sometimes it can be, right?
You know, but still want to be very intentional about not just being like, well, this is better because it's a natural supplement cuz hemlock is natural and that didn't work out so well for Socrates. Yeah. Yeah. So, okay.
So, is there anything else? I feel like we've touched all the points. Is there anything else you can think of that we need to I don't think so. I mean, you know, again, just uh so know where your supplements are coming from. Make sure they're coming from they're good bioavailable micronutrients. micronutrients.
Yeah. There's some third party certificate of analysis behind that. Um Um right. Supplements are not created equal.
I mean that I think that's the biggest thing is like just that one step of saying does it you know when patients say well I know this one's really good. I go call a company. Yeah. And ask and tell them here's a lot number. Can you send me the certificate of analysis?
And either they'll say no we don't. We're not required to do that. or they'll say, "Yes, we do that, but we don't release it to the public." Okay, that for me is a big red flag. Or, "Yes, we're happy to supply that for you. What's your email?" Right? So, that that's a very simple way.
I feel like you can cut across the supplement industry and probably 97% of supplements don't pass just that one test, right? So, that's a that's probably the easiest way to requires a little more work and but that's what we have to do. You really do get what you pay for, you know? I would agree. Yeah. Yeah.
Like most things in life. That is true. Okay. Thank you very much.
We're wrapping up uh episode 12. Awesome. Thanks, guys.