Laura Schoenfeld: It really depends on the condition that the person has, and it also depends on… the question that was originally asked about level of complexity, so if you have a patient that is going from a Western diet to a Paleo diet and you’re concerned that they’re not going to be getting certain nutrients because they won’t be eating certain foods. A great example of this is liver. Most people that are switching to a paleo diet from a Western diet are not going to necessarily start eating liver on a weekly basis, so for example, vitamin A, that might be a nutrient that you’re a little concerned is not going to be provided in that diet.
There are a few nutrients that we typically recommend for most people just because they’re really hard to get enough of. Magnesium is a good example of a mineral that is challenging to get enough of even in the most well-constructed Paleo diet. Most people can benefit from a little supplementation there. There are some other ones, like vitamin C. A little bit of vitamin C for people is usually pretty good. Vitamin K2 is a nutrient that most people don’t get enough of, and it’s essentially nontoxic. There’s never been any toxicity established for K2, and it helps make sure that vitamin A and vitamin D are doing their jobs. I know high-dose vitamin D supplementation tends to be pretty popular with a lot of alternative doctors, and really physicians, in general, are starting to pay a lot of attention to vitamin D, but vitamin D without vitamin K2 is actually pretty dangerous, so vitamin K2 is one that I would say most people could benefit from a small amount of supplementation.
I’m trying to think… there may be some other ones that are pretty consistently helpful, but again, it may just depend on the patient’s issues. For example, if someone has major skin issues, then perhaps doing a vitamin A supplement along with D and K2 would be helpful. If they’ve been a vegetarian for a long time, they might need some B12. They might need some zinc.
Testing for deficiencies can be helpful, and if you have blood tests that show, for example, iron deficiency or B12 deficiency or folate deficiency, there may be things that you know are deficient that should be supplemented with to replace. But if somebody is just kind of going from a normal American diet to a Paleo diet, a lot of the nutrients that they weren’t getting on their original diet be covered, especially the fat-soluble vitamins. You can use tests to show deficiencies. I typically use more clinical evidence as far as the person’s symptoms are concerned, and there are certain nutrients that are really important for specific symptoms. Like I said before with skin health, vitamin A tends to be helpful. If somebody is coming off of a certain type of medication that tends to use up a lot of nutrients—birth control, for example—I usually like to give B6 because B6 gets drained on birth control.
It’s really going to depend on the patient, but things like magnesium, vitamin C, vitamin K2 … I’m trying to think if there are any other supplements that are … I know that Chris has a list somewhere. I can see if I can find his article on that. Sorry I’m doing Google searches, guys. I just want to make sure that I recommend the ones that Chris recommends. And like I said, I usually use the patient’s individual needs to guide the recommendations. Chris’ short list of what most people supplement with is A, D, K2, magnesium, and vitamin C. Those were the ones I had mentioned.
Vitamin D is one of those ones that I think Chris is a lot more conservative than the average physician or alternative health practitioner is, so vitamin D recommendations from him probably would be a lot lower than the typical ones you’ll see other doctors recommending. That doesn’t mean that you shouldn’t use it. It just means that it should be in moderation.