So Many Dietary Supplements – How Do You Choose?

When I started using dietary supplements in my cardiology practice, there weren’t a lot to choose from. In fact, there were so few truly good products that I began formulating my own so I could make sure my patients got exactly what they needed.

Today, though, the exact opposite is true. There are so many vitamins and nutritional supplements available that deciding what to buy can be overwhelming.

Which ones do you most need?

What’s the best value for your money?

What’s the best way to use supplements, without needing to take dozens of pills?

If you have the means, it’s always best to work with a nutritionally-minded doctor who can create a supplement regimen that addresses your specific health needs. But if you don’t—or if you just prefer more of a DIY approach—you want to choose supplements that will help you achieve two goals: (1) reducing inflammation and (2) increasing your body’s ability to produce energy. If you can do those two things, you’ll be well on your way to a long and healthy life.

Based on my experience and research, I currently believe that – in addition to a high-potency multivitamin and mineral supplement with B vitamins and antioxidants – there are five must-have supplements that everyone should take, regardless of health status. They are…

Coenzyme Q10

CoQ10 was my first love in the dietary supplement world, and it’s still my Number One must-have nutrient.

Most of all, I love CoQ10 for the heart. Why?  It’s one of the raw materials needed to produce ATP, the body’s most basic form of energy. Without enough ATP, the vibration and metabolism of our cells slow, and the cells become more susceptible to disease. This is especially important for our cardiovascular health because the heart requires more energy than any other organ in the body. If it begins to fail, you’ve got real trouble.

CoQ10 also has powerful antioxidant properties, which makes it an effective tool for knocking out the free radicals that cause inflammation.  

Our bodies naturally produce CoQ10, but the amount of it we make begins to fall around age 40. Not surprisingly, that’s also about the time when a lot of folks begin to notice that they’re more easily fatigued than they used to be. Our cellular energy production certainly factors into that, so I was never surprised when patients reported feeling a little more “pep in their step” after starting a CoQ10 supplement.

Another group of people who tend to be low on CoQ10 are people taking a statin drug for cholesterol or heart disease. Statins block the metabolic pathway that the body uses to make CoQ10—so it’s essential that you take a CoQ10 supplement if you’re on one of these medications, or you risk long-term damage to your health.

Recommended dosage: 50–100 mg daily; 100–300 mg if you’re on a statin drug or have other heart health concerns.

Omega-3 Essential Fatty Acids

The omega-3 fatty acids DHA and EPA are called “essential” because our bodies can’t produce them on their own—we have to consume them through our diet. That means a lot of cold water fish like salmon and sardines, nuts and seeds (flaxseed, in particular, is often cited as an omega-3 source), and to a lesser extent, leafy green vegetables and DHA-fortified eggs.

Unfortunately, most of us don’t eat enough of these foods to keep our omega-3 levels where they should be. Plus, the omega-3s that come from plant foods aren’t actually DHA or EPA—they’re another type of omega-3 called ALA (alpha-linolenic acid). The body has to convert ALA into DHA and EPA, and that conversion process doesn’t always work as well as it should.

The takeaway? Omega-3 essential fatty acids need to be on your must-have supplement list!

Omega-3s are especially beneficial for the heart, helping to lower blood pressure and triglycerides, thin the blood, and reduce inflammation. They also give the brain a boost, reinforcing the connections between neurons.

Marine oils like fish, krill, and even algae are good sources of supplemental omega-3s, but I like squid oil the best. It has the highest concentration of DHA, which is the most-used EFA by both your heart and brain. Squid also has a short lifespan, so it’s sustainable and there’s little chance of heavy metal contamination, which can be a risk with fish oil products.

Recommended dosage: 1–2 grams daily. If you take a prescription blood thinner, like warfarin, stay on the lower end of this recommendation, to avoid too much thinning of the blood.

Resveratrol

I like resveratrol because it does lots of good things in the body. Most importantly, it’s a potent anti-inflammatory agent, but I also appreciate its ability to supports heart health and healthy blood sugar.

Resveratrol comes from the skin of grapes, where it’s a natural protector against fungi, insects, and other environmental threats. In the body, it also has protective effects, helping to stop free radical activity and slow down the inflammatory response. This means your cells suffer less oxidative damage, so they vibrate faster and age slower. It’s also, no doubt, why resveratrol supplementation has been associated with improved circulation, lower blood pressure, and healthy arterial lining.

Taking a resveratrol supplement can be especially helpful if you have diabetes or blood sugar concerns.  Studies have linked the nutrient with lower blood sugar levels, better insulin sensitivity, and added protection against diabetic neuropathy.

Recommended dosage: 30 mg daily; up to 250 mg daily if you have diabetes.

Turmeric

As a supplement, this bright yellow spice—known mostly as an ingredient in curry dishes—has exploded in popularity in recent years. If you’re not already taking it, you should. It’s one of the most potent weapons you can use to fight inflammation and progressive, long-term disease.

Turmeric’s power comes from its most active ingredient, curcumin. One of the ways curcumin benefits our health is by slowing several of the body’s main inflammatory pathways. It’s also a strong antioxidant, so in addition to being able to control inflammation in the body, it can help prevent it from starting in the first place. This double-dose of anti-inflammatory activity translates into a healthier heart and arteries, better circulation, less pain, and a more effective immune system (to name just a few).

One of the things I most love about curcumin, though, is that it has the ability to cross the blood-brain barrier. That makes it especially effective at stopping inflammation and oxidative damage in the brain, which drives Alzheimer’s, Parkinson’s, and other neurological diseases. We’re also learning that curcumin and resveratrol work synergistically, so combining the two just increases overall benefits.

Recommended dosage: 250–500 mg daily. Be sure to shop for a supplement with solid bioavailability data, since some turmeric supplements are not very absorbable. One tip: Look for formulas that include black pepper, since the active ingredient in pepper helps the body take in turmeric.

Broad-Spectrum Magnesium

Of all the nutrients on this list, you might think magnesium is the most ordinary. It’s anything but!

Magnesium is a key player in more than 300 enzymatic reactions in the body, including the production of ATP in cells. Plus, we need it to help regulate muscle and nerve function, heart rhythm, blood pressure, bone strength, blood sugar levels, and dozens more health markers.

All that, combined with the fact that we just don’t get as much magnesium from our diet as we used to, make this mineral one of my must-have supplements.

There are a lot of different magnesium supplements available, but you’ll get the best results from a broad-spectrum formulation. “Broad-spectrum” simply means the product is made from different forms of magnesium. My favorites are magnesium orotate, magnesium citrate, magnesium taurinate, and magnesium glycinate, because they’re easier for the body to absorb.

Recommended dosage: 400–800 mg daily. Some people who take magnesium experience loose bowels. If that happens to you, simply reduce your dosage, and the problem should take care of itself. Also, be careful with magnesium if you have kidney issues, because it can put additional strain on those organs.

You can safely take all of these supplements on their own or in combination with each other. I would suggest taking them with food, however, since that often helps with absorption and potential stomach upset.

In closing, I would add just one more thing. Even though dietary supplements are a great way to improve your health, never, ever use them as a substitute for a healthy lifestyle. Supplements work best when they’re combined with healthy habits like following the PAMM diet. So add them to your health regimen. You’ll notice the difference!

References and Resources:                                                                                                      

© 2017 HeartMD Institute. All rights reserved.

Leave a Reply

27 Comments

  1. Janice Dupuis

    on September 19, 2017 at 1:38 pm

    Are these supplements safe to take with heart medications like Ramipril and Bisoprolol?
    And how do we know we’re getting the best quality of a supplement and not ones that use fillers etc.?

    Thanks,
    jan

  2. Jim Dillon

    on September 19, 2017 at 8:14 pm

    Dr Sinatra,
    Thanks so much for your books and this web site.
    I have a question that I think many of your followers would like the answer to: When should one take the above supplements? All in the morning? Some at night? Not important?
    Thanks!

  3. HeartMD Editor

    on September 28, 2017 at 10:16 am

    Hi Jim,

    Thank you for your question. It is best to take supplements in divided doses, with food. So, after breakfast, lunch and dinner is ideal. However, 3 times per day can be too much for many people so after breakfast and dinner works! L-carnitine, if taken separately, is best on an empty stomach.

  4. John

    on October 2, 2017 at 12:26 pm

    Dr Sinatra,
    Thanks so much for all.
    Sorry for my english,but im writing from Italy.
    I have a question that I think many of your followers would like the answer to:
    recommended dosage in hearth failure after cardiac surgery with Ecmo.
    Thanks!

  5. John​

    on October 3, 2017 at 2:44 am

    Dr Sinatra,
    Thanks so much for all.
    Sorry for my english,but im writing from Italy.
    I have a question that I think many of your followers would like the answer to:
    recommended dosage in child hearth failure after cardiac surgery with Ecmo.
    Thanks!

  6. HeartMD Editor

    on October 5, 2017 at 10:44 am

    Hi Janice,

    It should be fine to take these supplements with the heart medications you are on. However, you must always check in with your doctor first and let them know what supplements you want to take. Understandably, it is confusing trying to navigate the big wide world of supplements and vitamins and there are so many to choose from. As for the quality of them, we can only speak to the quality of Dr. Sinatra’s line of supplements and vitamins through Healthy Directions (DrSinatra.com) – they all go through strict quality assurance.

  7. Ian Lawson

    on October 18, 2017 at 6:38 pm

    I have been taking Q10 and magnesium since your earlier advice and at 84 now telling Cardiologist I am not going on paying him to tell me nothing every 6-12 months. Echo readings went up as soon as I started on above and Mitral valve not yet dead. Thank you.

  8. Joe

    on October 18, 2017 at 8:19 pm

    Which of these supplements, if any, should not be taken with Plavix?

  9. Carole Martin

    on October 18, 2017 at 8:25 pm

    Should a person who eats healthy diet containing lots of fresh fruits and vegetables also take a multivitamin?

  10. Anne Foster Angelou

    on October 18, 2017 at 11:37 pm

    I am taking a small dose of metoprolol (25mg in the morning and 25mg in the evening). I also take a very small dose of lisinopril (5mg once a day). I just ordered several bottles of Dr. Sinatra’s BP Support but it says to check with my physician if I am taking BP medicines. I want to take this supplement. I have not asked my cardiologist here in Seattle but he has a complete list of all my supplement thus far (not including BP Support) and he says he sees nothing of concern. He just wants to know what I’m taking. I’m hesitating to begin taking it because of the caution on the bottle. Please let me know. Thanks, Anne, in Seattle, WA.

  11. Frank Verano

    on October 19, 2017 at 12:11 am

    I desperately needed this. I am 99 now and aiming for100 in a couple of months. Thanks!

  12. Lida Krieger

    on October 19, 2017 at 7:39 am

    Great information from a trusted source!
    But I am stumped in trying to find a multivitamin with minerals. Can Dr. Sinatra offer any help there? Some claim to be food derived and many go well above RDA guidelines.

  13. Lida Krieger

    on October 19, 2017 at 7:48 am

    I see now that Dr. Sinatra offers a multivitamin
    Should all 3 tabs be taken at once after breakfast or divided?

  14. HeartMD Editor

    on October 19, 2017 at 9:37 am

    Hi Ian,

    We are very happy to hear that you have had improvements since taking the Q10 and magnesium. If you have not done so already, I’d recommend that you check out Dr. Sinatra’s book: The Sinatra Solution: Metabolic Cardiology and the article Metabolic Cardiology Basics. Both describe the top supplements Dr. Sinatra recommends for heart health.

  15. HeartMD Editor

    on October 19, 2017 at 9:51 am

    Hi Linda,

    Many vitamins supply more than the RDA guidelines, this is quite common. They stand as minimum requirement and it can be beneficial to go higher in many cases (though “mega-dosing” is never recommended). Dr. Sinatra has a very carefully formulated multivitamin and mineral formulation for both women and men.

  16. HeartMD Editor

    on October 19, 2017 at 9:53 am

    Hi Linda,

    It is best to divide the doses. One at breakfast, lunch, and dinner is ideal, but if twice a day works best, you can take 2 instead of one at your AM or PM dose.

  17. HeartMD Editor

    on October 19, 2017 at 10:03 am

    Hi John,

    When dealing with heart failure, I would recommend that you refer to Dr. Sinatra’s book: The Sinatra Solution: Metabolic Cardiology and the article Metabolic Cardiology Basics. Both describe the top supplements Dr. Sinatra recommends for heart health and the appendix of the book has his specific supplement recommendations for heart failure.

  18. Lida Krieger

    on October 19, 2017 at 10:17 am

    HeartMDEditor,
    Should all 3 multivitamin tabs be taken at once after breakfast? What is the best protocol?
    So much appreciate the ability to get feedback from you and others who write.

  19. Rebecca Hadley

    on October 19, 2017 at 1:05 pm

    I suffer from Gastritis, Diverticulosis, Irritable Bowel, Gerd/Reflux and I have been taking your Probiotic Solutions Extra. Is there anything else that would help my stomach problems?

  20. HeartMD Editor

    on November 8, 2017 at 12:28 pm

    Hi Joe,

    The supplements listed have not been problematic in Dr. Sinatra’s patients taking Plavix. However, you must discuss taking them with your doctor.

  21. HeartMD Editor

    on November 13, 2017 at 11:01 am

    Hi Anne,

    It sounds like your doctor in Seattle is open minded about supplements. It would be good for you to bring the Blood Pressure Support formula to review with him. The warning is just to be sure you are not combining it with digoxin or other glycosides (digitalis). You may be able to reduce your blood pressure medication by taking targeted supplements to help control it. Please discuss doing so with your doctor.

  22. Neal A.

    on November 17, 2017 at 6:48 pm

    History: 2016 LAD attack, 90%, stent put in. Rx: Carvidilol, low dose aspirin. Following Sinatra protocol.
    D-Ribose, Carnitine, omega 3, cod liver oil, probiotics, coq10, Vit C, proline, Lysine, Magnesium. great stress tests! can I ever drop CARVIDILOL? No statin, taking Poliscanol. Type 2 diabetic controlled /Berberine. Hawthorne extract ok?

  23. Neal Alston

    on November 17, 2017 at 6:50 pm

    ok

  24. Susan M.

    on November 18, 2017 at 8:31 pm

    Hi Dr. Sinatra,
    Thanks for your books and this website. Could you recommend an integrative cardiologist in New England? My home state is NH. I winter in FL. I have had CABG x 4 in 2007at age 60.

  25. HeartMD Editor

    on November 20, 2017 at 11:07 am

    Hi Susan,

    You can see Dr. Sinatra’s Top Docs list here. Please note that many of the doctors can do phone consultations so don’t hesitate to contact one that is not in your local area.

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