Are You Taking Too Many Vitamins? The Critical Nutrients You Need and the Ones You Don’t Need As Much Of with Chris Kresser

Interactive Transcript

Speaker A Hi everyone. Drew proud here. You know, everyone's looking for that magic pill or the next big longevity supplement to perfect your health and prevent disease. And there's a whole supplement industry that is selling you that promise. You know, I'll be the first to admit I myself have a very full supplement cabinet filled with all sorts of things that I'm trying and my favorites that are out there that are based on the evidence. And still, every so often I want to hear an argument about, about the fact that maybe we're overdoing it with supplementation, maybe even getting too much of the wrong nutrients that are out there and not enough of the ones that actually matter. Which is why I'm sharing a segment of my conversation with a functional medicine specialist and expert and clinician, Chris Kresser with you today. Chris Kresser is the founder of the California center for Functional Medicine, the founder of the Kresser Institute, and the host of the top ranked podcast Revolution Health Radio, and the creator of Chris Kresser.com, an incredible collection of articles there that I regularly turn to to help me figure out and guide myself on all things health and wellness. Chris is also the best selling author of the Paleo Cure and the book Unconventional Medicine. And in our conversation today that we're featuring a moment from, we break down the hidden risks of over supplementation, the most commonly missed nutrients and the ones we might be getting too much of, especially when it comes to popular supplements like vitamin D, iron and even calcium. And more importantly, we also explore how our bodies actually absorb and utilize these nutrients and why bioavailability matters and how nutrient synergy or how vitamins like D, K2, magnesium and a all work together. And if you're like me and have an overflowing supplement cabinet or you're wanting to optimize your health and nutrient status, but wondering if it's enough to just focus on a nutrient dense diet. You're gonna want to stay tuned to this featured segment from a past interview. So let's jump in to my conversation with Chris Kresser.

Speaker B Which nutrients can you get too much of?

Speaker C Right.

Speaker B I think that's important this day and age where we all I'm guilty is included first. I'm in this industry. I'm always trying different stuff that are there. But like anybody else, I have a big cabinet full of a lot of different supplements that are there. And even though I'm the person in this field that's asking questions, I'm by no means the expert. I'm just proximity to A lot of the experts like you out there. I often wonder myself, like, am I getting too much of this particular thing? So are people, or is there a risk of getting too much nutrients? Especially when people are looking at their diet with supplementation?

Speaker C Yeah, I think with food it's pretty unusual to get too much of a nutrient because the body has mechanisms for avoiding that when the intake is through food. So, for example, with iron, usually if you eat more iron than you need, you just excrete the remainder. And there is a caveat there where some people who have a genetic condition called hemochromatosis that leads to excess storage of iron even when they don't need any more iron, and they can get dangerously high iron levels. But that's a genetic issue. It doesn't affect, you know, most people. So usually when you're eating food, you're going to. You're gonna. It's gonna be much safer. The issues start with supplementation, typically. And, you know, I wanna provide the caveat that nutrient inadequacy is a way, way bigger problem. So I almost hesitate to talk about this, but I think you're right. It is a bigger problem now because you have so many people that are supplementing and so many people that are supplementing with, unfortunately, without maybe the right guidance or fully understanding, not, you know, their own fault, but just there isn't enough guidance on the supplementation process. So one example would be vitamin D. I just mentioned that it's. Vitamin D deficiency is a way, way bigger problem. And I've had patients come in to my clinic and I've tested their vitamin D, and it's 130. And that's a toxic level of vitamin D that can cause kidney stones and make your arteries stiff and increase the risk of heart disease. It's definitely problematic. And I asked them, you know, what's going on? You've been supplementing with vitamin D? Yeah, they've been taking 50,000 IU per day of vitamin D for, like, 10 years, you know, which is a dose that was way, way too high. And they never should have been prescribed that dose probably in the first place. Or they should have been told very explicitly, you know, only do this for a week and then stop and go back to, like, a more maintenance dose. But that's. That's happened more times than I can count in the last 15 years. Iron, I mentioned, is another issue.

Speaker B And just real quick, before you go to iron, share your thoughts on where you think ideal vitamin D numbers are meant to be right in the body. And it might be a little bit nuanced compared to maybe some of the stuff that people are hearing out there. And you written a whole article on this subject that I came across years ago. We'll link to it in the show notes as well. But yeah, can you share a little bit?

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Speaker C Yeah, it is nuanced. And even most recently, I've heard vitamin D scientists, people who've pretty much dedicated their entire career to studying vitamin D, advocate for what they call a personal vitamin D range. So this, this is an attempt to recognize that there are many different individual factors that affect vitamin D absorption and utilization and even demand and need, and that we need to really look at up our game and get more specific about what an appropriate level of vitamin D is for each different population or group of people. And I'll give you an example. People of African American descent tend to be more efficient at converting the inactive form of vitamin D to the active form of vitamin D. So they might not need to have serum vitamin D levels as high as someone of Northern European descent who is less efficient at making that conversion. Um, we know that I mentioned earlier in the show, people with obesity and metabolic issues have problems absorbing vitamin D from food and also converting sunlight into vitamin D. So they need more vitamin D than somebody who doesn't have those issues. Same for people with chronic disease. Vitamin D production from sunlight depends on so many different factors. Like here we are in Santa Monica, it's sunny, and outside, it's summertime. You could go outside and in 20 minutes probably produce all the vitamin D that you need. But if you're in Stockholm in the winter, you could spend eight hours outside and you're not going to produce enough vitamin D. So all of those factors combined, I'm going to try to make this as simple as possible. I think for the vast majority of people, a range between 40 and 60 is a good thing to shoot for. That's a range that studies have shown will, you know, optimize all of the functions of vitamin D and minimize any downside risks of having too much vitamin D. Now, in terms of how you get there, that's where the variance is pretty high. So some people don't even need to supplement at all, although that's in the distinct minority. Just getting enough sun exposure and eating, you know, cold water, fatty fish and pasture, raised meats and other foods that have, you know, some amount of vitamin D is enough for them. I'm actually in that category for most of the year. Other people need 10, 10,000 IU per day. I have many patients that need that just to maintain that range of 40 to 60. So what I recommend generally is people start with maybe 4,002 to 4,000 IU per day, and then they test, get themselves tested, maybe at the beginning of the fall before they're going into or in the fall, before they're going into the winter, see what their level is. If it's lower than that, they bump up the dose. Especially because they're going into a time of year, typically that is less sunlight, less sun exposure. And then they test again the following spring. See where their levels are and adjust accordingly. If you don't have access to testing, 5000iu per day has been shown in numerous studies to be a safe dose for the vast majority of people and to be effective at reaching those levels for the vast majority of people. So if I were to boil it all down, simplify it to that, that would be my recommendation.

Speaker A And other key nutrients.

Speaker B Again, there's probably a whole list, but specifically with vitamin D, if people are taking vitamin D, I think there's been a little bit of education, but still some people are in the dark about this. You know, you hear about K2, how important is K2, how important is magnesium? What do you want? People who have been taking vitamin D, especially because of everything that's happened over the last couple years, what should they know about taking vitamin D?

Speaker C Yeah, all of the fat soluble vitamins work synergistically together. So that's vitamin A, vitamin K2 and vitamin E are particularly important with, with vitamin D. K2 regulates calcium metabolism and helps with the, and vitamin D does that as well. So they work together to make sure that calcium gets deposited in the bones and the teeth and the hard tissues where we want it and stays out of the soft tissues. And that's one reason why when vitamin D is so high, it has the opposite effect. Actually. Calcium ends up in the soft tissues and causes, you know, kidney stones and those other problems that we mentioned. Magnesium, as we talked about, is a cofactor for vitamin D. And vitamin D requires magnesium to fulfill all of its functions. So that's very important as well. And then vitamin A, one of its main functions is to reduce the toxicity threshold of vitamin D. So let's say your vitamin D is at 75 and your vitamin A deficient. Well, you might actually experience vitamin D toxicity symptoms at that level because of that vitamin A deficiency. Whereas if you have plenty of vitamin A, even if your vitamin D is 100 or 110, you might be okay because of vitamin A's ability to protect against the toxicity of vitamin D.

Speaker A We.

Speaker B Talked earlier about organ meat and how that was a regular part of like people's diets back in the day. What about you growing up? Was organ meat a part of your tradition background or did you have to kind of get yourself into it as you started to go further down this.

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Speaker C It was not. I wish it was. I was actually just talking to my dad about this. He said he grew up eating liver, brains, kidney, pancreas. My grandmother, his, his mother was from the South.

Speaker B I know there's some people that are like, oh my gosh, like brain like this, like. But again, you go back far enough.

Speaker A Like all these cultures around the world.

Speaker B Even here in America. That's right, people were eating the whole animal.

Speaker C That's what my grandmother was preparing and she was from the south and that was a big part of her cultural tradition. And, and it extended to My dad, but it ended there. He didn't feed us that. But I do remember him ordering liver at restaurants sometimes, you know, when I was growing up that, you know, good restaurants would still often have liver on the menu. And I unfortunately did not develop a taste for organ meats. And I had, you know, still to this day, I struggle with it. I, I will sometimes eat them and I also supplement with them. But the organ meats are really, ounce for ounce, the most nutrient dense foods we can eat. And this has been shown over and over in studies and even studies that didn't take bioavailability into account, which was a huge shortcoming because one of the reasons organ meats are so beneficial is just how bioavailable the nutrients are in organ meats, which means how able we are to absorb and utilize those nutrients. And that was corrected in a recent study that was just published this year by Thai Beal and Flaminio Ortenzi. They were the first that I'm aware of to actually consider bioavailability. In their nutrient analysis, they looked at a whole range of commonly consumed foods, and they quantified nutrient levels according to the most essential vitamins and minerals that we need. And they were coming to this from the perspective of global nutrients, you know, hunger and nutrient deficiency worldwide. Like, because they, they were trying to answer the question, if we're going to try to correct the, this problem worldwide of people suffering from severe malnutrition and nutrient deficiency, how are we going to do that? Like, what are the foods that, ounce for ounce, are going to have the biggest impact on nutrient status worldwide? Well, what they found was that four out of the seven most nutrient dense foods were organs. So liver, heart, spleen, and kidney were four of the top seven foods. The other ones were small dried fish, dark leafy greens, and bivalves like oysters. So you have shellfish, organ meats, and dark leafy greens are the top seven. And they were not even close to other foods. So even muscle meats like steak or ground beef or things that we typically tend to eat were orders of magnitude lower than that. And then when you start looking at, like, beans and, and, and whole grains, which are typically touted as, you know, very healthy foods, they're, you know, again, several orders of magnitude lower. So I'm going to do this from memory, the lower score was better on the scale that they developed. Liver was 11, and whole grains were in the thousands, like 3,000, I think. So we're not talking about small differences. We're talking about huge, huge differences. And when I say nutrient density here, I should define that term. It's basically the concentration of micronutrients, vitamins and minerals and trace minerals in a given amount of food relative to the calories that that food contains. So if you take a food like flour, you know, wheat flour or sugar, the calories are extremely high and the level of nutrients are almost zero. They're almost completely devoid of nutrients. So they were off the charts of this nutrient scale, meaning. Or meaning they. They were so low in nutrient value that they didn't even. Couldn't even appear on the scale and. And be on the same graph, basically, whereas Liverpool is. So it's just almost pure nutrients based on the measurements that they did. So I think if we're interested in optimizing our nutrient density, adding organ meats and shellfish and dark leafy greens back into our diet is one of the best things that we can do.

Speaker B Any tips you got kids, any tips with integrating it into their life?

Speaker C Yeah, do it early is the first tip. Because if they can develop a taste for it early on, it's much less likely that they'll have a problem with.

Speaker B It and seem weird.

Speaker C Exactly.

Speaker B I mentioned this on a podcast recently, but just down the street from here in, we're in, like, the Santa Monica, Los Angeles region, there is a farm to table restaurant. It's called Farm Shop. And my first introduction to organ meat was a chicken liver mousse that they make. And it's like if nobody told you what it was, you'd just be like, wow, this is a great pate that I can add to whatever. You can dip veggies in it, other stuff. And a couple months ago, I took my younger sister there. She was in town with her baby and her husband, and we all had breakfast there. And they. The chef was like, oh, my gosh, like, I want to bring a few things for your baby to try. And he brought over the chicken liver mousse and some caviar and other stuff. And my little sister was like, she's in this world. And she actually went to school for nutrition and everything.

Speaker A She was a little bit like, I'm not sure. Is it early? Too early? Is it not?

Speaker B And he's like, come on. All the we know now. And her daughter is about, like 8 months old. He's like, we know the early introduction to a lot of these foods. Obviously, I think you've written a book on this topic or have a whole course on it, so you can chime in.

Speaker A They're all safe.

Speaker B They're all Safe and it's early enough. It's not like it's raw fish or whatever. And, and Leila, my niece, she loved it. She loved it. She ate it up. And we were all just chatting about, oh my gosh, imagine if we grew up with some of these super nutrient dense foods and they were just a part of our life. How much of a different world would it have been for us?

Speaker C Absolutely. Yeah. So our daughter, we fed her pate and like mousse and we would, when we lived in Berkeley, there was a kitchen called Three Stone Hearth where you could, they, they would prepare foods on the principles of the Weston Price foundation, which used, you know, really advocated for organ meats. And so we could go buy ground beef from them and it would already have liver chopped up, you know, and then seasoned. And so that's just what our daughter thought ground beef was and tasted like, you know, for the first several years of her life. And, and then, you know, we started giving her oysters, smoked oysters. You know, you can get smoked oysters in olive oil from whole foods in a little tin, for example, and she loved those. And so, yeah, like doing that, you know, combining liver with other foods, like in a, in a meatloaf. Like you could do a meatloaf, grain free kind of meatloaf with lots of seasonings, or you can do ground beef with like taco seasonings and chop up like just three ounces of liver to a pound or two pounds of beef. There are lots of ways that you can integrate it within, within your normal diet. That's not just like eating plain, you know, sauteed liver. Like that's for most people it's going to be hard to do that unless they grew up eating it and have already acquired not just a taste, but the texture of organ meats is different from the texture of muscle meats that we're used to eating. So.

Speaker B And where you live in Utah, are you buying these from like local providers or do you use any of the online services if you're going to look for that?

Speaker C Yeah. So in most places now in, you know, Utah especially, there's so many ranches around. So we get like a box of meat from a local ranch and then you can just ask to put in the the or, you know, to include organs. They don't get that request very often. They're happy to do it.

Speaker B They're like, oh, you must have a dog. And you're like, nope, it's actually for, it's for us.

Speaker C We also asked for the bones, you know, so we can make bone broth, but that's one option. A lot of places now have butchers. Like, the idea of artisanal craft butchers are coming back in a lot of cities. We had one in the Bay Area. We've got one in where we live in Utah now. And you're going to almost always ask the butcher for the organs as well. And they might even have good suggestions for how to prepare them because they're, you know, they're more accustomed to that. And then you have companies like US Wellness Meats and other online and they sell like Braunschweig and Pate and a bunch of different traditionally prepared types like ready made, Ready made. You just order it. It's in like a, comes in a kind of almost like I'm sure you've seen like the, it's like a tube of meat. It doesn't sound very appetizing, but it's, it's how traditionally those were made. Sure. And then you stick it in your freezer, you can pull it out, you can cut slices of it and put it on different foods. And so there's so many ways now to, to actually get it into your diet if you're motivated to do it.

Speaker B We started off the interview by talking about maybe the top three nutrients that are there. Let's expand on that a little bit further. So tease us out and take us down the list of other ones that are in the top ones, whatever it is, the top 10, 15, whatever, that are also key nutrients that we want to be paying attention to. So you talked a lot about vitamin D, magnesium, potassium.

Speaker C Right.

Speaker B What are some other ones you want to drill down that you feel like don't get enough attention but are still an important part of us living optimally.

Speaker C So vitamin K, we've touched on k and, and k2 briefly, but they're not the same. You know, they're in the same family, of course, but in the last 40 to 50 years, I think, you know, we really discovered that vitamin K2 has different functions than vitamin K1. K1 is mostly about clotting. And K2, as I mentioned, helps to regulate calcium metabolism and ensure that calcium gets into the bones and teeth and stays out of the soft tissues. And not surprisingly, studies have shown that when you don't get enough K2, your rate, your, your risk of heart disease goes up and your risk of osteopenia and osteoporosis, you know, bone related disorders goes up as well. And there are a lot of studies out of Japan showing that really high doses of K2 can help to even reverse osteoporosis in some cases. So K2 is a bit of a trickier one because it's not in a ton of foods that we eat in the US today, with the exception of cheese. So K2 is produced in the process of fermentation. So hard cheeses tend to be pretty good sources of K2. Pasture raised eggs can be a decent source of K2. Fermented foods like sauerkraut or kimchi, which I think more, more and more people are starting to eat, are good sources. Kefir is a pretty, pretty good source. And then you have the top source, which almost no one I know eats is called Natto, which is a fermented soy product that's popular in Japan. But it has a very, very strong flavor that people either hate or I guess some people love it. I was going to say hate or tolerate, but there are people who love it. So K2 is one that you could get enough of if you're eating dairy products and pasture raised eggs and other fermented foods. But if you're not eating those, you probably will need to. Choline is another really, really important nutrient that some studies have shown that 100% don't get enough, that the nurse's health data says 92%. It's really important for cellular health. And because choline is a constituent in cell membranes. And so if you don't get enough choline, I mean pretty much everything in the body is composed of cells. So if you don't get enough choline, nothing is going to work optimally, particularly brains and our brain and nervous system. So you can get all kinds of cognitive or neurological neurodegenerative issues as a result of choline deficiency. And guess what? One of the biggest sources of choline is liver. It's again not very easy to come by in the diet. So mostly animal foods and organ meats in particular are really good sources of choline. Calcium is a, is a really interesting one. I want to talk a little bit about calcium and vitamin A. So calcium, as everyone knows, I think now is really important for bones. And bone health in particular plays a number of other essential roles. One of the biggest issues with calcium is bioavailability. So when you mentioned nutrition labels, if you go into whole foods and you get like a bag of spinach, you know, in one of the pre washed bags, and you turn it around and you look at the label, it will say that it has a certain amount of calcium and a certain percentage of rda. What that label is not telling you is that you are going to absorb about 5% of the calcium that's listed there from that spinach, which is a big problem. Right? Like it should say that on the label. That's a whole nother tangent. But that's because calcium contains oxalic acid or oxalate. Oxalate binds to and inhibits the absorption of calcium. So even though there's a lot of calcium on paper and spinach, you're going to absorb very little of it. So I've seen studies that suggest you would have to eat about 16 cups of spinach to get the same amount of calcium that you get from 18 ounce glass of milk. Because the calcium in milk is something like 30 or 40% bioavailable versus 5%. So that's a huge difference. And I think a lot of people are not aware of that. So even though the studies say 44% of people don't get enough calcium, those, those numbers are not considering bioavailability. And if they did, I suspect that that would be more like 80 or 90% not getting enough bioavailable calcium that their bodies can actually use and absorb. Vitamin A is similar. The studies, the nurses health data says 43% don't get enough vitamin A, but that groups together retinol, which is the active form of vitamin A that does most of what we want it to do, and beta carotene or carotenes in general, which are inactive precursor forms of vitamin A. So it's true that the body can convert beta carotenes into vitamin A into active vitamin A. But that conversion is really variable. It can be as low as 5% and as high as 40, 45%. So if you're someone who's on the very low end of that range, you can eat all the carrots and red peppers and beta carotene rich foods you want. The very little of that is going to get converted into retinol and you can still have a retinol deficiency. And I see that all the time. Keratosis, polaris, which are the bumps on the back of the arm, typically in the upper arm, that's a sign of vitamin A deficiency. It's really easy way to see if you might be dealing with that.

Speaker B A lot of just anecdotally, I'm just sharing here a lot of, because I grew up in the, you know, Indian background, ayurvedic, everything like that. A huge percentage of people are vegetarian. A lot of my friends who are still vegetarian anecdotally have a lot of Those bumps, not saying that it's only a vegetarian thing, there's other people that have it too. But it's just something that I remembered growing up.

Speaker C That's exactly right. And that's, that's often a consequence of that poor conversion. And this is where nutrient synergy to tie this all back together, the conversion of the less active forms of vitamins to the more active forms, whether we're talking about beta carotene into vitamin A or retinol or vitamin K1 can get converted into K2 or alpha linolenic acid, ala gets converted into EPA and DHA, which are the long chain omega 3 fats. There are numerous steps in that conversion pathway. All of those steps require various nutrients, you know, vitamins and minerals to be completed. So if you're deficient in any of those nutrients, your conversion of the inactive to the active forms is going to be much worse. So this is where the synergy of nutrients plays a role once again. So this is, you know, coming back to your question about other nutrients like vitamin A and calcium. Even though statistically we're seeing like, like, you know, only 40%, which is still nearly half the population, are not getting enough. If we took those factors that I just discussed into account, I think those levels would be even higher and, you know, similar levels of vitamin D and choline and potassium.

Speaker A You know, I hope this featured segment provided you with better clarity on the delicate balance of nutrient intake. And if there's one thing you're walking away from from today's featured segment, it's that more isn't always better, especially when it comes to nutrients. Your individual needs depend on so many factors. And getting a baseline through testing or working with a practitioner who understands that complexity or just doubling down on the basics that we know that are out there on top of a nutrient rich diet can be a game changer. And let's not forget, as we mentioned before, that supplements are only part of the equation. What you eat deeply matters. And as we heard, organ meats, shellfish, dark leafy vegetables and fermented foods are some of the most nutrient dense foods that are out there. I mean, they've been part of traditional diets for generations for a reason. So if you've enjoyed today's featured segment and would like to learn more about the increasing issues around nutritional deficiencies, how we got here and how to add back in what the modern world squeezed out, I highly encourage you to listen to the full length conversation with Chris Kresser. You'll find that link in the show. Notes below. And if you want to dig deeper into the world of supplementation, I'm also going to add a link in the Show Notes for one of my Try this newsletters on this topic, specifically titled three Overhyped Supplements and what to Take Instead. It's a fantastic article. It's a free read. Just click on it in the Show Notes below. Lastly, if you found today's episode valuable, consider sharing it with a friend or loved one who might benefit from it. You never know. This episode could help them rethink their approach to nutrition and supplementation, and most importantly, double down on the basics of a nutrient rich diet. Until next time. Thanks for tuning in.

Are You Taking Too Many Vitamins? The Critical Nutrients You Need and the Ones You Don’t Need As Much Of with Chris Kresser

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