Are you confused about supplements? Most of my clients are! Their “vitamin habits” run the gamut from never or rarely taking vitamins to taking upwards of 20 or 30 vitamins and supplements a day.

More than half of adults in the U.S. take supplements, and spend about $23 billion on them, according to a recent National Institutes of Health report. Most expect that they will feel better and have less chronic disease because of the supplements. But here’s the kicker: Most of us in the healing professions have had little or no training in nutritional supplementation! Unless we’ve enrolled in fellowships or had additional training, we don’t know how to guide clients in this area.

A lot of those vitamins and supplements are running through the gut and kidneys and aren’t even absorbed. (I don’t mean to trivialize this, but it does give new meaning to the phrase “money down the drain.”)

By definition, a vitamin is a compound in food that results in a deficiency disease if it is removed from the diet. The term “vitamine” was coined in 1912 by a Polish biochemist, Casimir Funk. It comes from the Latin word “vita” meaning life combined with “amine,” because the substance that Funk isolated from the husks of rice, called thiamine, was a chemical derivative called an amine. Funk proved that beri-beri (a weakening disease leading to paralysis and confusion) was caused by inadequate thiamine in the diet.

In the U.S., large-scale fortification of the food supply started in 1924, when iodine was added to salt to prevent goiter (a swelling of the thyroid gland.) In 1933, vitamin D was added to milk to prevent rickets (a disease of soft bones); 1941 saw flour fortified with thiamine, riboflavin, niacin and iron in response to nutritional deficiencies seen in World War II military recruits.

It is rare to see obvious deficiency diseases in America, but it is not rare to see poor nutrition or under-nourished people. We now know that vitamins affect all aspects of our health.

Most vitamins are isolated from plants; in fact there is a lot of data to support the many benefits of a diet that is high in vegetables and fruits. But it is apparent that commercially-grown vegetables have been bred to look nice in the store with a long shelf life. Nutritional concerns are often secondary. It’s clear to me we just can’t get everything we need from food alone. We are gradually figuring out the individual genetic “fingerprint” and now know, for example, that 30% of us don’t have the ability to break down folic acid to its active form. This genetic “glitch” can lead to neural tube defects, Downs’ syndrome, arthritis and more. Adding extra folic acid or supplementing with the active form of folic acid overcomes this genetic problem.

So until we have inexpensive technology to show us our individual genetic “blueprint”, then two questions remain: What nutritional supplements should I take? And where should I buy them?

My usual recommendations include a minimum of these six vitamins or supplements: a high quality Omega-3 fish oil, a multivitamin and mineral complex, a broad spectrum B vitamin, additional Vitamin D, additional iron (menstruating and pregnant women only), and a broad spectrum antioxidant. I add in other supplements based on clients’ specific needs.

I recommend high quality vitamins and supplements from a reputable company. I look for companies that can offer information on product quality (batch testing of each lot of supplement along with testing for contaminants) and are formulated to be absorbed into the bloodstream and body. Otherwise, your money might be going down that drain.

But the very first step to optimal health is good nutrition and a healthy digestive system! Check with your healthcare provider and/or a nutrition specialist, and get on the right track.