Personalized Vitamin Sites Grow Despite Doubts

By Lindsay Kalter
This article originally appeared on

I am Dr. Bruce Miller, the red text are just my comments

vitamins

When 37-year-old Charlotte Carrlito began using a personalized vitamin service in June, the company told her it found a higher chance of heart weakness in her DNA analysis. The service suggested she take magnesium to offset it.

Two months later, her mother had to suddenly have heart surgery.

Vitamins and Minerals: How Much Should You Take?

Vitamins and Minerals: How Much Should You Take?

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“She needed stents put in her heart. The doctors said it was a genetic condition,” says Carlito, who lives in Miami, Florida.

Carlito believes Curos’s suggestion will help her avoid surgery in the future.

Carlito is among a growing number of people using personalized vitamin services online. The companies create supplement plans for its customers based on lifestyle, health issues, and, for some services, genetic tests. Seventy-five percent of U.S. adults used dietary supplements in 2018, up from 65% in 2009, according to a survey commissioned by the Council for Responsible Nutrition.

According to the National Health and Nutrition Examination Survey, 31% of the U.S. population is at risk of at least one vitamin deficiency or anemia. Almost a quarter of all Americans are at risk of deficiency for at least one vitamin or anemia, the survey found, while millions more are close to deficient in multiple categories.

Doubts About Effectiveness

Despite the wide use of supplements, nutritionists aren’t sure they help. In fact, the jury is still out on whether vitamins are effective at all.

Jennifer Cholewka, a metabolic nutrition support specialist and registered dietitian at Mount Sinai Hospital, says there is very little evidence to suggest taking any type of oral supplement significantly improves health.

“If you are eating a balanced diet and living a relatively healthy lifestyle, there really is no definite need for a multivitamin,” she says. “No matter what, it’s best to get as many of our nutrients as we can from food. It’s not a quick fix.”

It would be more effective, Cholewka says, to instead put money toward a gym membership or healthier groceries.

“If a patient is coming to see a dietitian, we’d first address eating more whole foods, eating healthier, incorporating more lifelong habits into their lives,” she says.

Many Options Already Exist

Still, vitamins remain a fixture in the daily lives of most Americans. But rather than entering the marketplace blindly, people are using services that cater to their specific needs. Carlito answered a Curos questionnaire and submitted raw DNA from a previous Ancestry.com analysis before she began taking magnesium, omega-3, copper, and a Curos multivitamin. The process was free, she says, but she buys her vitamins exclusively from Curos now. The Curos multivitamin costs $39 for a monthly supply, which is comparable in price to other vitamins purchased online or in a store.

“Within a week, I noticed I needed less sleep and had more energy,” Carlito says. “I did definitely notice a difference in how I felt.

Supplements: What You Really Need

photo of father and daughter in sunshine
1/15Vitamin DIt helps keep your bones strong. People who have healthy levels of it may be less likely to get certain conditions, but more research is needed. Your body makes vitamin D when you’re in sunshine. It’s also in salmon, tuna, and fortified foods. If you’re low on vitamin D, your doctor may suggest a supplement. But several large studies show no benefits to otherwise healthy adults.
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Probiotics Also called “good” bacteria, probiotics are found in fermented foods like yogurt, kombucha, miso, and sauerkraut. They can change the balance of good and bad bacteria in your body and may help improve digestion, soothe skin irritation, lower cholesterol, support your immune system, and more. But it’s not yet clear if probiotics in supplements help treat conditions, and most people don’t need to take them every day.   
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Multivitamins If you know your diet isn’t that healthy, can a multivitamin help you fill in the nutritional gaps? Not necessarily. Many studies have found that multivitamins don’t fight memory loss, heart disease, or cancer. Meanwhile, getting too many nutrients in pill form can cause harm. Experts usually recommend food as the best source for vitamins and minerals.
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Folic Acid Here’s a vitamin you definitely want to make sure you have enough of if you’re a woman who’s hoping to get pregnant. Getting enough folic acid can help prevent birth defects in a baby’s brain and spine. You need 400 micrograms (mcg) per day, and the Center for Disease Control recommends taking that much in a supplement, along with whatever you get from your diet.  
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Fiber Supplements Fiber is in veggies, fruits, whole grains, seeds, nuts, and legumes like beans. It helps cut cholesterol, control blood sugar, and improve digestion. Women under 50 should get 25 grams a day, and men should get 38 grams. But most get only 5% of us hit those numbers. Taking a fiber supplement is usually safe, but ask your doctor, especially if you take medicines like aspirin. Start slowly to avoid gas and bloating, and be sure to get enough water.
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Fish Oil Fish like salmon and sardines have healthy fats called omega-3s that can lower your risk of heart disease. If you don’t eat fish, there are fish oil supplements with omega-3s, like EPA and DHA, and there are algae-based supplements. But more research is needed, because omega-3s in pills may work differently than the ones in fish. If you take a pill, the FDA says to keep the dosage to less than 2 grams per day of EPA and DHA combined. 
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Calcium Some research has linked them to a greater risk of heart disease and prostate cancer, but that link isn’t clear. You can strengthen your bones with exercise like walking, tennis, dancing, and lifting weights. And fill your plate with calcium-rich foods like yogurt, almonds, dark leafy greens (for vitamin K), and fish or fortified foods for vitamin D.
photo of glucosamine chondroitin pills
Joint Supplements Glucosamine and chondroitin, two types of arthritis supplements, are among the most popular supplements sold in the U.S. They are found naturally in human cartilage. Research on whether they can ease arthritis pain or prevent arthritis is mixed. Still, most experts say there’s no harm in trying them, in case you’re one of the people who gets relief from them. As with all supplements, it’s best to check with your doctor first.
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Vitamin C Your body can’t make vitamin C, so you have to get it from food. And it’s easy to hit the recommended daily amount. Just 3/4 cup of orange or half a cup red bell pepper both provide more than 150% of what you need. So you probably don’t need a supplement. There are popular products on the market with mega-doses of vitamin C that claim to prevent colds (or at least shorten how long they last), but research on that has been inconclusive.
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Melatonin This hormone plays a role in sleep. Your body makes it, and it’s sold in pill form. Because there’s not much evidence about the safety of taking melatonin long-term, you’re better off trying it for short-term problems, like jet lag or a temporary bout of insomnia. Side effects can include drowsiness, headache, dizziness, or nausea. Many people are able to get themselves off sleeping pills, with Melantonin.
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Magnesium This mineral supports your body in lots of ways. It gives you energy and keeps your heart healthy, for example. But even though it’s found in a range of foods, including nuts, seeds, whole grains, and leafy greens, most Americans don’t get enough. If you’re interested in taking a magnesium supplement, ask your doctor which type is best. There are several options.
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Coenzyme Q10 (CoQ10)This is an antioxidant your body makes, and you can get more of it in pill form. People try to use CoQ10 to fight migraines, protect the heart, and improve symptoms of Parkinson’s disease. But the research on whether it works is limited and conflicting. Side effects include insomnia and upset stomach, but they’re usually very mild. CoQ10 can interact with blood thinners and insulin treatments, so check with your doctor before taking it.
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Turmeric This yellow-orange spice may help tame inflammation, which is part of a wide variety of conditions. It’s not yet clear if turmeric thwarts any particular health problems. As a supplement, it’s sometimes labeled as curcumin, which is one of the active ingredients in turmeric that has been the focus of scientific studies. Up to 8 grams per day is considered safe. And it’s fine to add the spice to your foods.
photo of fish, meat, eggs and milk
Vitamin B12 You need it to make red blood cells and DNA and to keep your nervous system healthy. It’s found in animal products like fish, meat, eggs, and milk, so vegetarians and vegans may come up short, as can adults over the age of 50 and people with digestive problems like Crohn’s disease. B12 supplements are sold as pills or shots. B12 shots have become trendy as a way to try to boost energy and slim down, though no research shows they work.
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Keep in Mind Everyone is different. If you have a specific health concern that you think supplements might help with, ask your doctor. Your doctor can check to see what’s safe for you, tell you about potential side effects, and add your supplements to your health record. The FDA doesn’t approve supplements, unlike prescription drugs. So do your research and talk with your doctor first. 

Not all services use DNA to create customized programs. For example, the company Persona gives users a survey that takes 5 to 10 minutes to complete. It asks questions like “What are your top three health concerns?” and “What is your fitness or activity level?” It also asks how many servings of calcium, vegetables, and other diet staples the user gets in a week, and what medications they take.

Its staff includes five doctors, a registered dietitian, a pharmacist, and a team of nutritionists and other health professionals.

“We don’t hock pills, we provide education and information for free,” says Jason Brown, CEO and co-founder of Persona. “If an individual is interested in purchasing, they can buy with us. If they’re not, we don’t care.” People are either smart enough to understand that if they are going to take vitamins, they should be based upon their own personal DNA test, or their not.

Persona has about 90 different vitamins and dietary supplements, according to the company. There are 5 trillion combinations, and Persona has a database of over 1,000 prescription medications that is checked for potentially harmful interactions.

Brown says more than 1 million people have taken the questionnaire but did not say how many bought supplements from various companies.

The company’s top users are men and women over 35, he says.

“We call it the ‘bifocal era,’ ” Brown says. “The goal is to make sure we as a company promote healthy aging. Let’s face it, north of 70% of America is on medication.”

Incorporating a DNA test into the process allows these companies to assess whether there are certain vitamins that cannot be absorbed, says Golnoush Yazdani, marketing director at Vitamin Lab.

Conflicts, Benefits in Question

For example, those who have the MTHFR gene mutation cannot absorb folic acid or folate. This deficiency can lead to fatigue, weakness, shortness of breath, pale skin, and crankiness.

To get around the mutation, experts would likely recommend methylfolate, Yazdani says.

The cost of getting supplements from VitaminLab can average between $140 and $280, based on what is needed. Three months’ worth of vitamins are shipped at once.

Yazdani says its main audience is women ages 30-40, along with athletes.

“Because our soil is getting so depleted, we can’t get all of our nutrients from our food,” she says. “So supplements are getting more popular.” DNA Based Supplements are the future.

According to a 2015 study published in the journal Nature, Earth’s soil is less nutrient-dense as a result of depletion from human activity. A 2004 study evaluated 43 crops from 1950 to 1999 and found declines for six nutrients — protein, calcium, potassium, iron, and vitamins B2 and C.

But Cholewka says although there is probably some truth to this, the degree to which it would affect people’s health “would be negligible.”

On the other hand, if someone is going to take supplements, it is best if the vitamins are customized to fit their needs, says Angela Zivkovic, an assistant professor in the department of nutrition at the University of California, Davis.

“It is important to take only what is necessary, and take something if and when you need it,” she says and a personalized DNA test is the best way to know what vitamins and minerals your personally need.

More Information Needed

Though she likes the idea of personalized supplements in theory, the brief questionnaires likely do not cover enough ground for a full assessment, Zivkovic says.  

The micronutrient world is a complex one, she says. For example, if someone has megaloblastic anemia — which is linked to a lack of folate — taking a folate supplement would make the anemia go away. But it could also mask the symptoms of a B12 deficiency, which can lead to loss of nerve function.

Uforia Science is the world leader in DNA based supplements. As more and more people move towards personalized vitamins this is a company worth investigating.

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