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“The pharmacist”
Dietary supplements and vitamins: what makes sense – and what is profiteering
Our author and pharmacist Diana Helfrich takes various vitamin preparations and iron because she doesn’t have enough of them
© Photo: Henning Kretschmer; Illustration: Michel Lengenfelder
Pharmacists love nutritional supplements because they bring them good sales. But which preparations are useful? Pharmacist Diana Helfrich provides answers.
Of course, as scientists they look at it differently. The recommendations of the responsible specialist society, the German Society for Nutrition (DGE), are at least cautious: Unless you are a baby, are expecting one, want to get pregnant or don’t even come to the door, you don’t need anything except iodine and fluorine Fortified table salt, the experts say, has remained unchanged for many years. Because: Germany is not a country with a vitamin deficiency, dietary supplements do not protect healthy people from illness, but are taken to calm them down, according to them Professional society on their website. And further: It is not possible to compensate for a poor diet with a few pills.
What makes vegetables healthy are not the isolated ingredients such as vitamins or minerals. What counts is the entire package, including fiber and secondary plant substances, which the plant produces, among other things, to protect itself from predators (such as bitter substances). This was simply not known in the 1970s and 80s when the vitamin C and multivitamin effervescent tablets started to bubble up. The lack of benefit of vitamin preparations is offset by possible risks from overdose, as the specialist society also points out.
Zinc promotes testosterone production
I recently wrote for the “Diagnostics” section in star described the case of a young man who took 15 milligrams of zinc several times a day for better training effects during strength training, because zinc can promote testosterone production – and thus muscle building. He came to my conversation partner, a practicing cardiologist, with suspicion of Long Covid. Instead, he had severe copper and iron deficiencies. Because if you give your body too much zinc, it can no longer absorb copper, and it needs copper to absorb iron.
The German Nutrition Society only recommends taking vitamin D. It promotes the absorption of calcium from the gastrointestinal tract and helps incorporate the mineral into the bones. Vitamin D also plays a role in immune defense. It is a fat-soluble vitamin, meaning one that can accumulate in the body. That’s why you should at least take it in a higher dose (50 or 100 micrograms, but usually the international units are on it, which is 2000 or 4,000 IU) and not take it on your own long term and daily, like that the Federal Institute for Risk Assessment.
By the way, vitamin D is not actually a vitamin because, by definition, the body cannot produce vitamins itself. This is different with the “D”. It is mainly formed in the skin under the influence of UV rays, i.e. sunlight. On a day at the beach, for example, plenty of it is produced and stored in the muscles, fatty tissue and liver.
Only a blood test can prove a vitamin deficiency
The only way to determine whether you have enough vitamin D is to do a blood test, which then measures 25-hydroxyvitamin D. The probability that you are not receiving optimal care is comparatively high. According to the DGE, “almost 60 percent of German citizens achieve this desirable blood concentration of the marker 25-hydroxyvitamin D of 50 nanomoles per liter.” According to the specialist society, a large part of the population does not exploit the preventative potential of vitamin D for bone health.
If the worst comes to the worst, your doctor can prescribe a high-dose preparation (with 500 micrograms/20,000 IU) that you only take once a week – if it is the initial treatment of a proven deficiency, even with a prescription. This is something completely different than the over-the-counter products, some of which only contain 25 micrograms (1,000 IU). And many dietary supplements contain even less, especially multivitamin preparations.
So much for the official recommendations. But I don’t stick to it. Not only do I take vitamin D (my levels have been a bit low lately), but I’m also currently taking B-12 and iron (for the same reason). And I always buy a calcium supplement because I’m a middle-aged woman and I’m worried about my bones. Both of my parents have osteoporosis.
The trend is towards secondary plant substances
But what strikes me when I walk past the exploding shelves of nutritional supplements in the pharmacy or drugstore or am flooded with advertising on Insta: It’s no longer just isolated vitamins and minerals, the trend has been towards preparations made from secondary plant substances for years or simply plant extracts or powders that have been put together for a specific purpose and are called, for example, “Recharge” or “Full Lust”. And some of the vitamin supplements have become very lifestyle-oriented, appealing and expensive, and people are inclined to believe that they make everything better. There wasn’t a word about herbal dietary supplements in the DGE’s statement, and I also searched the website again: nothing.
I recently spoke to a doctor who takes 30 supplements a day. An optimal micronutrient supply can really bring you forward, she says. Especially when you’ve already completed a medical marathon, all your values are fine and you still just don’t feel healthy.
Because for some people, a value that is already in the recommended range is not optimal, according to the belief of the so-called nutrient therapists who want to heal and prevent diseases with the body’s own substances – they use vitamins, minerals, amino acids, essential fatty acids, but also highly effective hormones. This is currently a trend; people often talk about “functional” or “orthomolecular” medicine.
So it’s no longer about popping a few pills and then getting a bag of sour fries and a Sprite for lunch. On the contrary. These are very health-savvy people who care. Those who want to make it even better. Those who have the money to buy such products. And to afford individual nutritional advice, because you can get this from doctors who bill privately and take their time. Doctors who not only take blood, but also ask and look closely and then write a private bill for 180 euros.
The question of the placebo effect remains unanswered
For the DGE and all other purists, this would probably be a pure placebo effect if you feel better with nutritional supplements. I wish there were studies that would clarify how high the proportion of this effect is. But because they are considered food, dietary supplements may be sold without extensive approval studies, so there is and will be no hard data. So we shouldn’t expect any certainties at this point. Except this: The experts’ recommendations are outdated. They have been overtaken by our Insta world, which is keen to optimize and loves products.
Note: The column cannot provide individual advice Pharmacy replace the package insert or the medical diagnosis and treatment.
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