Which supplements really work and which to avoid when it comes to menopause symptoms, heart disease, mental health, and pediatric nutrition.
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Illustration by Orlando Hoetzel
Google “vitamin supplements” and you’ll be rewarded with more than half a billion hits. Popping a pill that’s not actually a pill is a popular topic, and for some patients, a popular alternative to lining up at CVS to pick up a prescription.
Many medical professionals, however, are skeptical that vitamins and supplements are useful for preventing and treating illness in the average patient. To help sort through the noise—and save you the Google search—we checked in with some of the Commonwealth’s leading experts to get the latest information on how supplements relate to three common concerns: menopause symptoms, heart disease, and mental health.
Hot Flashes
When it comes to purchasing supplements to relieve menopause symptoms, “It’s buyer beware,” says Jo Robins, a Ph.D. and holistic health nurse practitioner who facilitates menopause workshops at Virginia Commonwealth University in Richmond. Herbal remedies that are marketed to relieve menopause symptoms include chasteberry tree, dong quai, ginseng, licorice, and valerian.
So many options, and yet there’s only one that Robins recommends: black cohosh, an herb in the buttercup family native to North America. “That’s the only one the literature says works and won’t cause breast cancer,” says Robins. Because some hot-flash remedies mimic the effects of estrogen in a woman’s body, there is concern that some could be harmful. Black cohosh was cleared of that worry in a 2014 systematic review of available research, Robins says.
She noted that the herb has proven most effective during perimenopause, the decade or so before a woman stops menstruating. But black cohosh is not a cure-all, and Robins highly recommends that women try yoga, tai chi, and other mindfulness practices that can help counter the anxiety that comes with adjusting to hormonal changes. “I tell women, it is better to look inward than to look outward,”Robins says.
Because menopause affects a woman’s entire body, not just her endocrine system, some women experience bone loss after menopause. Robins cautions against automatically popping calcium and vitamin D. “Nothing can replace getting calcium through your diet,” Robins said. Women who have been diagnosed with osteoporosis and osteopenia are the exceptions, however, and should talk to a specialist to determine the appropriate doses of calcium and vitamin D.
Something Fishy
Virginia Heart Center cardiologist Dr. Subash B. Bazaz was attending the American Heart Association conference last fall when results of a study got the doctors so excited that you would have thought someone had announced free stethoscopes were available at the bar. “This has gotten a lot of buzz,” Bazaz says.
According to a government-funded study conducted by the National Lung, Heart and Blood Association, neither fish oil supplements nor vitamin D help lower incident rates of heart disease or cancer. “The study proved something we doctors had suspected for a long time,” says Bazaz. The randomized five-year study included 26,000 Americans over 50 with no prior history of cancer or heart disease.
However, there was one positive note in the study: The fish oil supplement did appear to lower risk of heart attacks for 28 percent of patients, although not of strokes. Among African-American patients, the heart attack risk was lowered 77 percent compared to those who took a placebo.
Bazaz says the latter statistic merits further study, and noted that some pharmaceutical companies are developing prescription-strength, highly refined fish oil supplements and claim the product is promising. He also notes that fish oil supplements are recommended for patients who are seeking to combat high triglycerides.
The tricky thing about researching vitamins and herbal supplements, Bazaz adds, is that they are studied far less than prescription medications, which are backed by pharmaceutical companies. “Most studies on supplements will never get done,” he says.
Warts and All
There is some data available on non-pharmaceutical supplements that can aid patients seeking to naturally improve mood disorders. A 2013 literature review—that is, a study that looks at all other studies—found that St. John’s wort, rhodiola rosea, omega-3 fatty acids, and S-Adenosyl methionine are effective in the treatments. The researchers also recommended lifestyle adjustments such as light therapy, yoga, acupuncture, exercise, and mindfulness practices. Things that aren’t helpful, according to the journal Neuropsychiatric Disease and Treatment, are vitamin B, vitamin D, and methylfolate.
Robins, who has some experience with alternative treatments for depression, has a special caution for women of childbearing age who may be taking St. John’s wort: The herb can alter the reliability of birth control medications, especially for women in perimenopause. For reliable information about nontraditional remedies, Robins highly recommends turning to the National Center for Complementary and Integrative Health’s website.
Children’s Vitamins: Should Kids Still Eat Their Flintstones?
Angie Hasemann Bayliss, a registered dietitian at the University of Virginia’s Children’s Fitness Clinic, wants parents to focus more on getting kids to eat their vegetables and less on chomping down on Fred, Barney, or Wilma. “If your children eat a balanced diet (rich in fruits, vegetables, whole grains, lean proteins, and adequate dairy), they’re likely getting the vitamins and minerals their bodies need,” Bayliss said in an interview published by the university last year. It’s only kids who are consistently refusing to eat a certain food group who may need that multivitamin, she points out.
Of course, parents of children diagnosed with special health concerns can always discuss adding vitamins or supplements with their pediatricians. And if your child is one of those taking a sugary Fred or an enticing chewy gummy, please make sure they are also brushing their teeth.
This article originally appeared in our April 2019 issue.
