I take around $30-50/month in supplements.
A standard medical education contains very little training in nutrition. The training that does exist is based on research that is mostly old, was directed at determining the absolute minimum intake that didn't cause very obvious clinical symptoms, and almost entirely excluded women test subjects. So no, I don't trust the average GP to tell me if a nutritional problem is causing my health difficulties; even a very motivated doctor would be basically self-educated and basing their opinions on a research landscape that would typically exclude subjects like me. It's also pretty well established that women's chronic health conditions are seriously under-studied, under-diagnosed, and under-treated.
So, while the supplement industry is unregulated and undeniably rife with quackery, the healthcare gap it is filling is very real.
I have had several MD-diagnosed vitamin deficiencies over my lifetime-- iron, B12, vitamin D-- and all of them felt awful. I don't know why my diet isn't sufficient (or my digestive system is failing to absorb? who knows?) but it clearly isn't. All the supplements I continue taking, I take because they seem to be improving the conditions I'm trying to manage with them.
It's a price I'm willing to pay as part of a self-experimentation process, in the absence of a robust research/clinical field of nutrition.
But, even as someone who has to use the extra-large pill organizer: $350/month is way too much.
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My current regimen, for any interested parties:
For autoimmune disease: Omega-3/DHEA/EPA, vitamin D. Both of these have a mood-boosting effect.
Supplemental fiber (my MD recommended this one although my diet does meet minimum fiber requirements)
For PCOS/perimenopause: inositol, chaste berry, raspberry leaf tea (the effects of this combo are undeniable-- lengthens my cycle by over a week and dramatically reduces bleeding, ovary pain, and dysphoria).
Iron every other day for the luteal & menstrual phases. I stop doing this, I become anemic, so I don't stop doing it. My iron is tested every year and it's never been higher than low normal.
For ADHD: vitamin C & zinc, and the aforementioned omega-3
I have tried supplements, had adverse effects, and stopped taking them. Melatonin seriously aggravates my autoimmune issues; I have nightmares, rashes, and serious joint/muscle pain. Most brands used to contain a warning that this could happen. Others I have tried and stopped because they just didn't seem to be effective. Some I use on an as-needed basis, like taking a course of probiotics after antibiotics.
I find this interesting since we seem to have similar issues (I have PCOS with insulin resistance, various autoimmune diseases, and malabsorption due to some sort of intestinal problem that is vaguely diagnosed as functional). I don't take any supplements apart from some supplemental magnesium for digestive issues, and occasionally vit D if I don't get natural sun for more than 3 days, which is rare. I take one multivitamin per week, but honestly I think that might be too often, given how nutrient dense my diet is.
I don't need any supplements to manage any of my health issues, at least not so far. I would try inositol (40:1 myo to d-chiro ratio) for insulin resistance if I needed anything to manage it, but that hasn't happened so far, it's been well managed and hasn't progressed for >20 years... :crosses fingers:
I tried some supplements in the past and either they didn't do anything notable or they added further symptoms or interactions that confused my health situation further (just taking a standard otc b-complex 2x per week for a year almost gave me permanent nerve damage due to b-6 toxicity, which luckily my endocrinologist had seen before and id'd in time).
I actually do not have insulin resistance, or at least not in any way that shows up in my blood work. The polycystic ovaries were found on an ultrasound when I saw a gynecologist about heavy bleeding. At my age, it's not exactly clear whether it's PCOS proper or early menopause, and I haven't been able to see a doctor who knows how to tell the difference (I am on a wait-list for a specialist 300 miles away). I gave the inositol a try because every time I ovulate, it hurts so much I can't walk and occasionally vomit, and the inositol stopped that.
My vitamin D is monitored every six months. I was clinically deficient even while taking 2,000 IU/day and didn't resolve until a rheumatologist put me on a prescription-strength dose. I lower it when I'm getting lots of sun but keep it pretty high in the winter. The research is very conflicting about vitamin D and it seems to affect different people very differently. I can tell you that a clinical vitamin D deficiency is no fun at all. I had the symptom they describe as "bone pain" and it sucks. Everything hurts.
You do have to be careful with B-vitamins. I don't take a multi because I'm really only trying to target specific things.
My diet could certainly be better, but it's really not bad enough to explain why my immune system started eating parts of me before I turned 18. I've never eaten what they describe as the Standard American Diet, and I've tried so many dietary variations-- gluten-free, vegetarian, dairy-free, vegan, keto-- but nothing has ever made a difference. I did use selenium supplements at one time and it cut my antibody levels down to about 1/3 of what they were at diagnosis, but once the deficiency was corrected, I stopped.
A good diet is wonderful, but sometimes health issues happen anyway, and there aren't always good treatment options. As people with chronic illness go, I'm actually pretty damn healthy. We e still have a lot to learn about how bodies work, especially when we begin looking at individual genetic differences.
Oh, for sure... I'm riddled with all kinds of health problems despite a healthy diet; seems to be just bad genetic luck since my sisters were raised the same way and don't have any of my issues. And autoimmune stuff is so weird and isn't understood well.
NOTE: It should be pretty easy to distinguish between premature menopause and PCOS if the doctor just runs the right tests. Any doc can run them, but it seems like a lot of doctors are kind of idiots about hormones. Also, just a note, most docs don't test correctly for insulin resistance, either. Most rely on fasting glucose and A1c or dismiss the possibility if you are not overweight. I'm thin as a rail but have had IR for >30 years with those values both being normal.
Just in case you need it, I can post all the tests required for proper diagnostic work up below. Typically, with premature menopause you will have low estrogen and androgens, high FSH compared with LH, and [SHIT; edited for a mistake I just noticed] low AMH. Typically, with PCOS you will have high androgens and/or low SHBG, normal to high estrogen, and high LH compared with FSH, and often high AMH. (Of course, there are exceptions in some individuals).
NOTE: If your prolactin is high (can occur from various things and 'mimic' PCOS, but can also occur as part of PCOS) be aware that it can be a huge autoimmune stimulator in some people. I get violent autoimmune flares from mild prolactin elevation (far lower than would occur, e.g., during pregnancy...thank god I never wanted to be pregnant) so I have to medicate my prolactin long term.
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PCOS is diagnosed by a combo of lab tests and symptoms, and diagnosis must be done while off hormonal birth control (or other meds that change reproductive hormones) for at least 3 months.
First, you have to show at least 2 of the following: Irregular periods or ovulation; elevated male hormones on labs; excess egg follicles on the ovaries shown on ultrasound
In addition, a bunch of labs need to be done to support the PCOS diagnosis and rule out some other stuff that presents similarly.
1. Reproductive hormones (ideally done during period week, if possible): estrogen, LH/FSH, AMH (the last two help differentiate premature menopause from PCOS), prolactin (this is important b/c high prolactin sometimes indicates a different disorder with similar symptoms), all androgens + SHBG
2. Thyroid panel (b/c thyroid disease is common and can cause similar symptoms)
3. Glucose panel to look for insulin resistance (see more discussion below). This is critical b/c most cases of PCOS are driven by insulin resistance and treating that lifelong is foundational to improving the PCOS (and reducing some of the long term health risks associated with untreated IR).
Depending on what your lab results are and whether they support ‘classic’ PCOS driven by insulin resistance, sometimes additional testing for adrenal/cortisol disorders is warranted as well. Those would require an endocrinologist for testing.
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Diagnosis of IR is often not done properly, and as a result many cases of early-stage IR are ignored or overlooked until the disorder progresses to prediabetes or diabetes. Late-stage cases of IR/prediabetes/diabetes usually will show up in abnormal fasting glucose or A1c blood tests. But early stages of IR will NOT show up.
Unfortunately, glucose and A1c are often the only tests that many doctors order, so you might need to push for more specific testing, and I would strongly encourage it if you exhibit any of the symptoms of IR, such as unusual weight gain/difficulty with weight loss; unusual hunger/fatigue/food cravings; reactive hypoglycemia (can feel like a panic attack with anxiety, high heart rate, weakness, faintness, tremor, etc.); frequent urination; brain fog; frequent infections such as yeast infections; intermittent blurry vision; mood swings; headaches; disrupted sleep (if hypo episodes occur at night); darker skin patches or skin tags.
The most sensitive test that is widely available for flagging early stages of IR is the fasting oral glucose tolerance test with BOTH GLUCOSE AND INSULIN (the insulin part is called a Kraft test) measured, first while fasting, and then multiple times over 2 or 3 hours after drinking sugar water.
This is the only test that consistently shows my IR during the past 30+ years.Many doctors will not agree to run this test, so the next best test is to get a single blood draw of fasting glucose and fasting insulin together so you can calculate HOMA index. Even if glucose is normal, HOMA of 2 or more indicates IR; as does any fasting insulin >7 mcIU/mL (note, many labs consider the normal range of fasting insulin to be much higher than that, but those should not be trusted b/c the scientific literature shows strong correlation of developing prediabetes/diabetes within a few years of having fasting insulin >7).
