Whether you are a dedicated, seasoned supplement-taker, or an “on-again-off-again” one, invariably there are moments of secretly doubting whether they really work. In Part I of our interview with Kirstin Nussbruger, she began lifting the veil off of myth surrounding supplements by focusing on whether it is necessary to take them at all, when to take them and why certain brands are considered to be of much better quality than others.

Let’s continue the conversation.

So how can I be sure then that I am getting what I am paying for?

You actually are asking if you can trust the company, correct? I can highlight 3 things for you here:

• Strict quality control. Higher quality brands are more than happy to disclose where and when they sourced their ingredients. They often go beyond the FDA’s imposed standards of “Good Manufacturing Practices” which refers to the actual manufacturing process, sanitation of buildings, the processing of all ingredients and distribution channels.
• Label information. Is the list minimalist, or does it give specifics? Does it just say “calcium…500mg”, or does it give details as to the actual form of calcium (because there are many…) such as “calcium citrate” or “calcium carbonate”. It is important to know the difference. If you happen to suffer from low stomach acidity, the calcium carbonate form may not be well absorbed, you would do better to use the citrate form.
• Promises made. Are they promising things like “this product will heal you of all illness in 30 days or less” or “this product ensures a long life”? No further comment.

Is there such a thing as a “natural” supplement? Aren’t they all synthetic anyway?

Yes, there is. Chemically speaking though, both natural as well as synthetic nutrients have the same chemical elements, but their molecular structure differs, sometimes, quite significantly. It seems the body can tell the difference with the natural being able to be absorbed better than the synthetic (Prasad, 1994).

So called “food-based” supplements are made by combining natural vitamins to live yeast cultures. The resulting fermentation process enables the yeast to incorporate the nutrients, thereby becoming part of a living food. It is said that these supplements get better absorbed as they offer a synergistic effect with the other nutrients in the foods. The down side is that food-based supplements usually have lower potencies, requiring you to take a number of tabs at one time to achieve the desired nutrient level.

Another “natural” approach includes freeze-drying whole foods through a process of flash or low-heat pasteurization, and then encapsulating the concentrated product. This assures a blend of nutrients (whole foods-style) that you would normally not get with chemically-pure vitamins alone.

I get confused with all these options of tablets, capsules, gel-caps and time release ones. Which one is better?

Me too, sometimes! Let me ask you: How quickly do you want the benefits? Which one goes down your throat the easiest?

• Tablets have a longer shelf life but due to their pressed nature may cause difficulty if you have poor digestion. Sometimes heat is used during tablet processing, which destroys some nutrients.
• Capsules make their content available more quickly than tabs. Enteric-coated capsules release their contents in the intestine and bypass the acidic stomach, which could destroy some nutrients.
• Gel-caps may be the easiest to swallow due to their soft gelatin casing.
• Sub-lingual tabs, sprays and creams are absorbed through your skin and thus enter your blood stream more quickly as they can bypass the digestion process.
• Time-release products dispense their content over a 6-12 hour period. The nutrient is encased in tiny micro-pellets which are then combined with a special base. This makes them more expensive. You could easily take a few regular tabs at regular intervals during the day, rather than 1 time-release one, if you don’t mind taking more than 1 tablet.

I keep on hearing the term “bioavailability” – what is that exactly?

If a particular supplement has a high bioavailability it simply means that your body can easily absorb it and put it to use pretty much right away. Supplements that dissolve the quickest have the highest bioavailability. Why don’t you test at home how quickly a supplement disintegrates? Take 1 cup water, juice of ½ lemon (to mimic stomach acid), add your supplement, stir gently, and see how long it takes to fall apart? A max of 45 min is ideal (Werbach, 1997).

I often hear that the body can only absorb so much, the rest is flushed down the toilet? Is this true?

Yes, sometimes the body knows when it has had enough of a good thing and needs to get rid of any excess. This is different for every one of us, and depends on a number of factors, including your current health and nutritional habits. However, research has shown that many nutrients that are not systemically absorbed into the blood—where you want your nutrients to go—remain in the intestines and have an important function there. Vitamin C and calcium, for example, enhance healthy flora in the gut and prevent some substances from being converted into carcinogens there (Prasad 1994).

Again, of benefit here is the type of supplement you choose. Mineral absorption can be enhanced by offering these in a chelated form. During chelation a mineral will bind with another substrate, such as an amino acid which the body can absorb more readily, thus making the mineral more bioavailable. Products with more absorbable mineral chelates cost more, but you get the best benefit.

Which supplements do you take?

I always get asked this! I will be quite frank here. I would not have coped with, nor recovered from my cancer treatments as well, had I not had my personalized, extensive supplement protocol under close supervision, not from my conventional oncologist, but my integrative physician and naturopathic doctor. I firmly believe in supporting my body with high quality supplements on an ongoing basis, with supervision. The body’s needs change, and this needs to be accounted for.

I also take breaks from my regimen, most often during summer, where I will give myself a break for a week or two. I also switch brands now and then as the body can get used to a particular composition. Luckily, there is sufficient high quality choice out there today!

The top eight of my protocol always include these:

• Probiotics
• Digestive Enzymes
• Vitamin D
• Turmeric
• Spirulina
• Chlorella
• a blend of Essential Omega Fish Oils
• and a Multi-Vitamin Combo with the methylated forms of both Vitamin B12 and Folate.

So you still recommend multis even with the recent controversial findings we heard about in the media?

Media loves controversy, that is a given. So when yet another nutritional bomb is dropped, I am always rather skeptical, as they never disclose the full details of the study they are basing their headlines on. Research studies can vary substantially in terms of consistency in findings, population samples used and methodology applied. A good quality mulit-vitamin is always an added bonus, but should not be seen as a replacement for a wholesome way of eating.

Let me conclude with my food mantra: Nothing beats whole foods. Eat clean, eat rainbow and eat fresh. That way you are most definitely assured a broad spectrum of nutrients, and your supplements can stick to the sidelines to cheer you on. Kirstin Nussgruber, C.N.C., EMB is the founder of Eat Holistic, LLC where she offers cancer-fighting nutrition and lifestyle modifications through personalized coaching, talks and interactive programs such as the online Beyond Cancer Program. Kirstin also heads the cancer support program at Valley Integrative Pharmacy in Bedminster, NJ. Kirstin features regularly on the “Holistic Around Hunterdon” Internet Radio Show and is a contributing author of Sybil Magazine – For the Spirit and Soul of Woman. EatHolistic.com.