Your essential supplement masterclass – the smart guide to supplements, part 2

In part two of the smart guide to supplements, Dr Linia Patel gives you a supplement masterclass, looking at the daily essentials and topical supplements.

In Part 1 we asked  Is a Balanced Diet Enough?

• The current nutritional gaps most people face
• Key questions to ask yourself before taking a supplement

Part 2: Your Supplement Masterclass

• The daily essentials: multivitamins, omega-3, vitamin D, vitamin C, B vitamins, collagen
• Topical supplements: probiotics, collagen and adaptogens

Do multivitamins work?^1,2

A large clinical trial that was over a 10-year period on groups of people over 45 years of age showed that multivitamins do nothing to prevent disease or to improve long-term health. The results show that unless there was a particular need to add in extra iron, omega, etc. (for example, if you’re pregnant or eat a vegan diet) then taking a multivitamin doesn’t help reduce the risk of cancer or heart disease.

While this study suggests that multivitamins just don’t have enough of the right vitamins, you do get people who swear by them! Which is the famous placebo effect. So, if your daily multivitamin makes you feel better and it’s not breaking the bank then it won’t harm you and by all means continue to take it.

A daily vitamin C for your immune system?^3,4

Vitamin C is found in a wide range of fruits and vegetables, yet it remains one of the most popular supplements worldwide. Many people turn to it, especially in winter, believing it helps protect against colds and flu. For adults aged 19-64, the recommended daily intake is 40mg, which can usually be met through diet. Since vitamin C is water-soluble, the body doesn’t store it, meaning we need a daily supply from food sources.

When it comes to immune health, research suggests that vitamin C only provides noticeable benefits if your intake is low or if you have a physically demanding lifestyle. In these cases, a supplement may offer some immune support. Some studies indicate that taking 1,000mg of vitamin C alongside 15-30mg of zinc at the first sign of a cold could reduce symptom severity by up to 1.5 days.

However, it’s best to stop supplementation once you feel better and get your vitamin C from food sources. If you have diabetes, consult a healthcare professional before taking high-dose vitamin C supplements, as some studies suggest they may raise blood sugar levels.

Should we all be on vitamin D?^3,5

In part one, we learned that many of us in the UK are deficient in vitamin D. When you scan the body for vitamin D receptors you find them pretty much everywhere. This means that it is a nutrient that not only supports our bones and immune system, but it influences many systems in the body such as the brain, mood and insulin sensitivity, as well as hormonal production. The UK government recommended adult vitamin D dosage is 400 IU (10 μg) per day when the sun is at its lowest (from October to March).

People with darker skin tones or gut issues or inflammatory bowel disease may well need a higher dose of up to 25mcg (1000 IU) or possibly more. To know how much vitamin D you should have when, I would strongly suggest you get your vitamin D levels tested; it’s an important one to get right as low vitamin D levels have far-reaching effects.

Optimal levels are 70-80nmol/L. Based on your bloods you can get supplements with the right doses. It’s a fat-soluble vitamin so, if you take it, ensure you have some fat in your stomach to enhance absorption.

What about B vitamins for energy?^3,6

There are eight different B vitamins (B1,2,3,5,6,7,9,12) that all have unique roles in the body but collectively work together to support and regulate energy, mood levels and cognitive function. Our requirements of B vitamins increase with stress and with alcohol consumption. B12 is found predominantly in animal products like eggs, dairy and meat and that is why non-meat eaters are recommended to take a 10mcg B12 supplement daily.

Some breakfast cereals will be fortified with B vitamins. A lot of the research into the effectiveness of vitamin B has looked at mood and cognitive function. However, low levels of B6 have been found to impact progesterone production and there is some interesting research suggesting that B vitamins may also possibly help with hot flushes.

More research is needed before we can draw firmer conclusions. However, deficiency in any one of the vitamins can have serious problems. B vitamins are water-soluble vitamins, which means they are not stored and should be consumed regularly from food. If you are feeling stressed, some people find that taking a B complex supplement for a couple of weeks to support their adrenal health helps when they are under pressure.

Omega-3 supplements: Hype or health essential?^7,8,9

Omega-3 fatty acids are essential fats that are important for health and have anti-inflammatory properties. Recommendations for essential fats vary widely from country to country; however, most health organisations recommend an intake of at least 250-500mg of combined EPA and DHA per day. The last dietary survey in the UK showed that, on average, we were getting around a third of that. The most positive research within omega-3s has been linked to its impact on mood and behaviour. There have been some links to low levels of omega-3 also causing dry skin and hair.

Ideally, we should all eat a little more oily fish or eat plant-based omega-3 sources like seaweed, walnuts, flaxseeds or chia seeds. If you want to know your omega 6/3 ratio, there is another blood test you can do that can help you understand if you need supplements or not, but this is not a routinely done test. There isn’t an agreed dosing for supplementation. In my clinical practice, I recommend that for therapeutic doses you need to look around for a 1,000mg combined EPA and DHA from fish oil. Vegans can opt for algae oil. According to the European Food Safety Association, omega-3 fatty acid supplements can be safely consumed at doses up to 5,000mg per daily.

Probiotics, collagen and adaptogens: Do these trendy supplements live up to the promise?

Category	Key Points
Probiotics10,11	Live microorganisms that support gut health, found in fermented foods (yogurt, kefir, kimchi, etc.) or supplements. – Supplements mainly useful for antibiotic use, IBS and traveller’s diarrhoea. – Lactobacillus probiotics may help with vaginal health. – Daily use is not necessary or recommended; if you take a probiotics supplement, take for eight to 12 weeks and track symptoms. – Not a cure-all but generally safe.
Collagen12,13	Most abundant protein in the body, found in skin, bones, tendons, nails, hair and even the gut. – Production decreases with age and most supplements come from marine (fish) or bovine (beef) sources. – Research is limited but suggests benefits for joint health and anti-ageing. – Daily intake for eight to 12 weeks is needed for visible effects. – No official dosage guidelines; consult a nutritionist for best results. – Safe with no upper limit, but high-quality supplements are recommended. – Long-term use required for lasting effects.
Adaptogens14,15,16,17	Herbs and mushrooms believed to help the body cope with stress and boost immunity. – Used in Ayurvedic medicine for centuries, now more accessible in Western diets. – Common examples: ashwagandha, rhodiola, maca, ginseng, Reishi mushrooms. – Limited but promising research suggests they interact with the HPA axis to regulate stress and energy metabolism. – Best used occasionally when the body needs support. – Rotate adaptogens every six weeks to maximise benefits. – Timing matters: stimulating adaptogens (e.g., rhodiola) should be taken in the morning; calming adaptogens (e.g., Holy Basil) in the evening.

 

Can you over-supplement?

Absolutely! While getting enough vitamin D3 is essential, too much can lead to toxicity. To prevent this, don’t exceed 4,000 IU per day unless advised by a healthcare professional. Similarly, excessive calcium supplementation can increase the risk of arterial calcification, making it crucial to approach supplementation with intention rather than taking a random assortment of pills.

Long-term use of isolated supplements without monitoring can disrupt the body’s natural balance. Minerals interact with each other. High doses of zinc, for example, can lead to copper deficiency because zinc upregulates copper absorption proteins, which can block its uptake. Likewise, calcium and magnesium share absorption pathways, meaning an excess of one can reduce the absorption of the other.

So, you don’t want to supplement willy-nilly. You want to be clinical with your supplements. Are you filling a gap or are you rectifying a deficiency? Are you doing it to get a within range or optimal outcome? How long are you taking the supplement for?

In my clinical practice, I always recommend testing before committing to long-term supplementation, especially for vitamins and minerals that are not water soluble. Water-soluble vitamins, like B vitamins and vitamin C, are excreted in urine when taken in excess, making them generally safer to supplement. Fat-soluble vitamins, such as A, D, E and K, are stored in the body, meaning excessive intake can lead to toxicity. Key minerals, including magnesium, zinc, copper, calcium and iron, should also be monitored carefully to ensure you’re not overdoing it. The other supplements I would be using on a case-by-case, symptom-by-symptom, goal-by-goal outcome – always keeping personalisation at the heart of it.

Summary

• If you want to take a multivitamin as an insurance policy, that’s fine, but research shows isolated forms aren’t very effective.
• Water-soluble vitamins like B vitamins and vitamin C can generally be supplemented without blood tests; however, vitamin C is most effective if used just at the signs of your first symptoms vs daily.
• Eat your probiotics!
• Think twice before supplementing with a fat-soluble vitamin. Get your levels tested first to see if you need them.
• When supplementing with individual minerals, don’t assume more is better or that longer use is more effective. Work with a nutrition expert to determine your individual needs.
• Some supplements are best cycled in and out, so be sure to work with a nutritionist to determine the best dosage and pattern for you as an individual.

 

References

1. British Dietetic Association. Supplements. Accessed here: https://www.bda.uk.com/resource/supplements.html
2. Loftfield i(2024), Multivitamin use and mortality risk on 3 prospective US cohorts, JAMA Netw Open, 3, 7(6): e2418729.
3. National Health Service. Vitamins and Minerals. Accessed here: https://www.nhs.uk/conditions/vitamins-and-minerals/
4. Maggini S et al, A combination of high-dose vitamin C plus zinc for the common cold, J Int Med Res., 40(1): 28-42.
5. World Medical Association. Vitamin D insufficiency. Accessed here: https://www.wma.net/policies-post/wma-statement-on-vitamin-d-insufficiency/
6. Hanna et al (2022), B Vitamins: Functions and uses in medicine, Perm J., 29, 26(2): 89-97.
7. Mohamady M (2018), Effect of omega-3 supplements on vasomotor symptoms in menopausal women: A systematic review and meta-analysis, Eur J Obstet Gynecol Reprod Biol,. 228: 295-302.
8. EFSA assesses safety of long-chain omega-3 fatty acids. Accessed here: https://www.efsa.europa.eu/en/press/news/120727
9. Chae M et al (2021), Association between dietary omega-3 fatty acid intake and depression in post-menopausal women, Nutr Res Pract., 468-478.
10. Lagowska K et al (2022), Effects of supplementation on gastrointestinal symptoms in athletes: A systematic review of Randomised Controlled Trials, Nutrients, 14(13): 2,645.
11. Gupta V et al (2024), Effectiveness of vaginal probiotic supplementation on the prevention of recurrent urinary tract infections: a randomized, double-blind placebo-controlled trial, Clin Infect Dis., 15, 78(5): 1,154-1,161.
12. Martinez Puig et al (2023), Collagen supplementation for joint health: the link between composition and scientific knowledge, 8, 15(6): 1,332.
13. Rustad A et al (2022), Myths and media in oral collagen supplementation for the skin, nails and hair: A review, J Cosmet Dermatol., 2: 438-443.
14. Ajala TO (2017), The effects of adaptogens on the physical and psychological symptoms of chronic stress, Discovery, 4: 2.
15. Zhang H et al (2020), Characteristics of Panax ginseng Cultivars in Kora and China, Molecules, 25(11): 2,635.
16. Panossian A et al (2021), Evolution of the adaptogenic concept from traditional use to medical systems: Pharmacology of stress and aging-related diseases, Med Res Rev., 41(1): 630-703.
17. Lopresti A et al (2019), An investigation into the stress-relieving and pharmacological actions of an ashwagandha extract: A randomised, double-blind, placebo-controlled study, Medicine, 17186.