The case against nutritional supplements

Here is a hyperlink with slides from the talk I gave today at the Ancestral Health Symposium 2013 in Atlanta.  I will upload a video of the talk once the organizers make it available.  Until then, you can click on the “Link to audio recording”  to listen to a recording that one of the conference attendees made and posted on YouTube.   The sound is a bit faint, but still audible, and should make the slides more intelligible.

Todd question AHS2013 - Copy

This presentation is based on material from several previous blog posts

The talk includes some new material not covered in those previous posts, in particular addressing antioxidant recycling, supplementation of calcium and the essential fatty acids EPA and DHA.  I have also provided a list of references of supporting studies and literature in the final 3 slides.

I enjoyed meeting many new faces and recognizing old ones at this year’s AHS.



  1. aerobic1


    Excellent presentation, thank you.

    The dose-response curves of hormetins show the potential for benefit effect of exogenous agents at lower intake levels and an adverse effect at higher intake levels. I understand the concept. How do we relate this effect to actual intake amounts of those agents? I too am skeptical of exogenous antioxidant substances, particularly at high doses as they, at some point, become prooxidant and likely cause defective autophagy.

    • Todd

      Yours is the 64 dollar question. Ideally, we would consult dose response curves before consuming a hormetic compound or engaging in a hormetic activity like exercise in fasting. In practice, the data collected in a lab is an average for some highly controlled population of animals, plants or microbes. Not many experiments of this type are ever performed on humans, so there is just not much published data we can use for dosing compounds like curcumin and alcohol, much less activities like lifting weights or cold showers.

      Add to that the fact that all of us differ in our biological tolerance to different compounds. Some of this is genetic (e.g. we have different levels of detoxification enzymes like alcohol dehydrogenase) and some is experiential, based on our prior exposure to hormetins. So each of us will have a different dose-response curve, and it probably changes over time.

      The best I can suggest is self-experimentation. Start with a low or modest level and frequency of the hormentin and observe the effects on your functional performance and certain biomarkers of health or fitness. Some have suggested that wearing a heart rate monitor and measure HRV (heart rate variability) is a good way to get a picture of the short term impact of some intervention (diet or exercise) on your health.

      This is a very interesting topic and one I’m actively exploring. Would love to hear suggestions.


  2. aerobic1

    From a free radical point of view, measuring SOD and Glutathione levels may offer clues as to effectiveness of hormetin efficacy. Low levels of these endogenous antioxidants should improve with optimal levels of hormetin intake. One would need an assay to determine their baseline and then follow-up assays as the level of hormetins are increased. Once the SOD and GSH begin to decline with increased intake may indicate one has passed the optimal intake level and is on the downside of the dose-response curve.

    Oxidative stress assays such as TBARS (thiobarbituric acid reactive substances) which is direct measure of lipid peroxidation may be another useful tool. It could be applied in a similar manner to the above SOD and GSH.

    I use recovery time from strenuous physical exercise as a marker for dose-response physical stress. Too hard, or too long of duration will exacerbate tissue damage and stall recovery time. This is very subjective but works well if one knows their physical capability and is in tune with how they feel.

  3. Oliver

    Todd, without a perfect diet i.e. strict paleo (say you were eating mostly non-organic animal meat and fish, complex carbs such as potatoes/rice with each meal, and a “okay” amount of veggies per day + some dairy products and a a couple cheatmeals per week/eating out) so “healthy” but not “perfectly primal” does your general thesis on the use of certain supplements change?

    I’m just trying to find some balance here since context is everything. When you give advice regarding certain supplements you seem to do so from the context that “everything else is perfect” rather than “pretty good considering how busy you are”.

    • Todd


      You are correct that “context is everything”; the value or harm from supplementation depends upon the context of diet, general health, and genetics. The studies out there give us at best the average effects on study populations that are typically composed of diverse individuals. So what they tell us about a group may or may not apply to you specifically.

      The general point of my blog post is that the purported benefits of most nutritional supplements (reduction in oxidative stress, strengthening of bone bass, hormonal balancing) are better addressed by attending to diet and exercise — and without the risks of down-regulating your in-built defenses. If your diet and exercise are not “perfect” but still mostly based on non-inflammatory whole foods, and you are physically active — then you are probably better off without supplements. Supplements are useful mainly if you need to redress an acute deficiency, if you are ill, have an infection, are pregnant, or have special athletic goals. You can always check your status with blood tests, but I would pay more attention to your functional health (i.e. your energy, strength, fitness, quality of sleep, etc.) than blood levels. If you are going to supplement, I would think about doing so only intermittently or for relatively short periods of time (months), rather than as a daily routine for the rest of your life.

      I realize this answer may not be very definitive, but it is hard to give you an absolute answer. The studies on supplements are themselves not definitive or consistent. So to some extent you have to rely on an understanding of what “health” means. Is health merely a set of numbers, and freedom from overt illness or — as I believe — a functional state of strength and resilience: the ability to take on life’s challenges without being “propped up” from artificial interventions like medications, supplements, immune boosters and suppressors, eyeglasses, and all manner of human inventions that promise immediate relief at the cost of sapping our longer-term fortitude?


  4. Cu Chulainn

    hello Todd,
    i know you praise Art De Vany, who swears by glutathione supplementation–

    any comments on this? this is the product he uses:

    thanks for your work.

    • Todd

      Hi Cu,

      I do agree with DeVany on the key role that gluthione plays in combatting oxidative stress. But rather than taking exogenous glutathione, I would prefer to focus on how to improve your ability to recycle and “recharge” your glutathione levels, particularly intracellular levels. Glutathione is most effective when it is at the right place, at the right time, at the right level. (In fact, excess antioxidant levels in the wrong place can interfere with the positive role that oxidation plays in intracellular signaling and muscular activity).

      DeVany himself is eloquent on this point in another of his posts on glutathione:

      “Glutathione recycling is a separate function from just boosting glutathione levels through a liposomal cream, intravenously, a nebulizer, a suppository, or other means. These forms of glutathione delivery will help one’s antioxidant status but they do not raise levels of glutathione inside the cells.”

      Glutathione is “recharged” by chemically reducing it — adding back hydrogens. This is done via the enzyme glutathione reductase. And how is that done? The best way is to be sure your diet includes Nrf2 activators, principally phytonutrients typically found in plants, just as I advise in my post on “The case against antioxidants“. DeVany also recommends this:

      “Fortunately studies also show various botanicals, nutritional compounds, and their cofactors have been shown to activate glutathione reductase and the synthesis of reduced glutathione.”

      Among the phytonutrients he recommends are cordyceps, gotu cola, and milk thistle. I would highlight others such as curcumin, and sulforaphone found in cruciferous vegetables.


      • Van

        What about the importance of sulfur containing amino acids as regards endogenous glutathione production?

  5. Cu Chulainn

    thank you. interruption of taking De Vany’s product (Guardian) did led to premature greying, which supports your argument. do you have any suggestions on how such damage (De Vany article above, free radical theory of graying) might be reversed, by analogy with your other hormetic approaches e.g. myopia? grey hair does seem to be an accurate indicator of overall oxidative damage.

  6. Sarah

    Hi Todd,
    I find that when I tried to begin a supplementation program (raw whole food multi, biosil, omega 3, turmeric, grape seed extract, tart cherry, and a few others) my face which is normally clear became filled with acne which took a good six weeks to clear after stopping. I’m a 38 year old woman.

    I have recently started Isagenix 30 day cleanse after my sister had good results on this with her IBS symptoms. The program includes a.m. And p.m. vitamin packs. I don’t normally suffer from headaches but I have had debilitating headaches every night since starting this.

    I truly wonder if these supplements are making me ill… Or if these are just symptoms of “detoxing.” It’s hard to know. I follow a paleo diet with as much organic as possible.

    Also, I recently quit a very high-demand, stressful year-long job during which I went from being in great health to gaining 30 lbs, and having all manner of digestive, sleep, and respiratory issues as well as all-over chronic pain. I get colds/flu easily. I feel depressed as well. I haven’t gone to the doctor because I know they will want to put me on antidepressants and GI medications. I am an RN with a biology degree also… I know enough to know that the medical establishment will want to throw chemicals at me, it will be expensive and I still won’t get answers as to what is underlying my declining health. I thought quitting the job and taking some time off to rest, regroup, and find balance was the answer, but truthfully, I find myself sicker and more exhausted now that I’m home full time. I find interesting the theory of progressively challenging ourselves to become more vigorous and healthy. I don’t really know what steps I should take, I just know I’m tired of being sick and tired. Since I’ve always been very healthy, it’s daunting to know what to do when you become sick but don’t know what is wrong. Any thoughts you have would be greatly appreciated. (I’m somewhat at a loss now, thinking supplements, diet, and rest would help.)

    • Todd

      My God, Sarah, ditch the Isagenix shakes and vitamin packs.
      “Side effects could include hives, vomiting, diarrhea, skin rashes, swelling in the throat and possible loss of consciousness.”

      You rightly are suspicious of the medical establishment “throwing” chemicals at you. (I like that image). Sorry to disillusion you, but the nutritional supplement “establishment” is similarly guilty of throwing chemicals at you. The “vitamin packs” are somebody’s arbitrary mixture of dozens of completely unnecessary and overpriced compounds. Do you honestly know what you are ingesting? You and I are both trained in biology. Time to crack your old biochemistry book and update your nutritional knowledge.

      The pattern you describe of chronic stress, weight gain, digestive problems, chronic pain, vulnerability to colds etc. suggest that you would benefit from a very simple Paleo type diet, cutting out sugars and starchy vegetables (bread, rice, pasta, potatoes). Just eat good old whole food: meats, fish, green and brightly colored vegetables (broccoli, peppers, cucumbers, squash, etc.). Replace sodas and fruit juices with water, whole milk, tea, herb tea or unsweetened coffee. Cut out snacks. Eat 2-3 solid meals, and don’t eat within 2 hours of bedtime.

      Pick up a copy of Robb Woff’s Paleo Solution or Art De Vany’s New Evolution Diet.

      Don’t go in for any commercial diet shakes or supplement program. Eat like our ancestors did.

      Do you exercise? I know it’s hard to think about that when you are feeling burned out and tired. But find a way to add two very intense workouts into your week. I’m not talking about walking or slow treadmill or exercycle. I’m talking something that makes you sweat gets your heart beating hard – weight lifting, spinning class, swimming laps.

      And please don’t take vitamins or antioxidants. They cancel out the benefits of exercise:

      Give it two weeks and let me know if your energy comes back.


  7. Van

    The only blood test that can diagnose vitamin D deficiency is a 25-hydroxy-vitamin D [25(OH)D].–> Yes, 25-OH-D is the only test we can be sure will be low in vitamin D deficiency, and 1,25-OH-D is not a good indicator of vitamin D deficiency. HOWEVER, while all vitamin D deficient patients will show a low 25-OH-D, not all patients with low 25-OH-D are vitamin D deficient.

    Certain inflammatory conditions cause excess macrophage (not renal) conversion of 25-OH-D to 1,2-2OH-D, leaving 25-OH-D low, even though there is no vitamin D deficiency. Furthermore, supplementing those patients with vitamin D based upon the low level of 25-OH-D will cause hypervitaminosis D extreme enough to cause bone resorption.

    The one fact about which we can be absolutely certain as regards primitive man, is that he was exposed to natural light 365 days each year, and never exposed to one minute of unnatural light. Assuming that the very earliest humans evolved relatively close to the equator, their problem was not getting sufficient vitamin D, but protecting themselves from an excess — thus, the darker skin of equatorial people. As humans migrated further from the equator, the lighter skin (less melanin pigment) evolved as a compensatory mechanism so that adequate vitamin D could be obtained. Obtaining vitamin D even in temperate climates should be no problem at all — it takes very little sun exposure even in the middle of December to get adequate vitamin D — if — a person goes outside for 2 hours midday. (Did you ever wonder how animals with a thick coat obtain enough vitamin D? It is not that hard if you spend your life exposed to natural light.) The problem is most people spend an insignificant amount of time in natural light.

    ADDENDUM: There is new information on 25-HD being converted to 1,25-2HD not by the kidneys but by macrophages in sarcoidosis, rheumatoid arthritis, and other inflammatory autoimmune diseases, and perhaps even in fibromyalgia and chronic fatigue syndrome. Apparently there is a bacterial component to those conditions that stimulates the conversion by the macrophages.

    The point is that low 25-HD does not necessarily mean a vitamin D deficiency since the low 25-HD can be accompanied by pathologically high 1,25-2HD.

    Supplementing with vitamin D can not only exacerbate the autoimmune inflammatory condition but can cause such high 1,25-2HD to stimulate osteoclastic activity and bone resorption — the last thing to be expected from vitamin D supplementation. This research suggests that 1,25-2HD should always be tested along with 25-HD (and that accurate 1,25-2HD tests can only be obtained when the specimen is frozen).


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