Navigating the World of Supplements: Expert Insights with Melissa Altman RN, CFMP, CCWFN Holistic Health Insights from Melissa Altman: A Guide to Safe and Effective Supplement Use

Introduction to Melissa Altman RN, CFMP, CCWFNIn this article, we’re thrilled to bring you expert insights on supplements from Melissa Altman, RN, CFMP, CCWFN—a Certified Holistic Health Coach and Functional Medicine Practitioner with over 12 years of experience in holistic health. Before transitioning into functional medicine, Melissa spent 20 years as a registered nurse, giving her a unique perspective that bridges both conventional and holistic approaches to healthcare. As a partner with Tikvah Health and Wellness, Melissa provides exclusive discounts to our members to help them access top-quality care. Dive into this interview to learn more about her expertise regarding choosing, using and understanding supplements for optimal health. To learn more about Melissa, visit her official website.Questions and AnswersQuestion: What exactly are supplements, and how do they support overall health?Answer: Supplements are things we add into the body when we have inadequacies. So for example: if we need to add-in or supplement something, then we should know what we're trying to supplement. Or do we have nutrient deficiencies that we're trying to supplement that we're not getting in our diet? A lot of times we are supplementing because of what's been done to our food. Food quality is so poor in many areas, unless someone is getting something from the Farmer's Market or they're growing it themselves. Then, we have foods that come from poor soil quality. We also have a lot of ultra processed foods in a lot of diets, which one of my goals is to change that and to try to help people eat food that they grow or kill. But we still have people that are not there yet, and we have to meet them where they are. And we also have a lot of medications that cause nutrient deficiencies that require augmentation with supplementing those nutrients because they're not coming in from the diet. So supplements are basically add-on nutrients that are missing from our diets. And the third point, and actually perhaps equally important is that a lot of things that affect supplementation needs are how much do we absorb what we take in anyway. So if digestion and absorption is already compromised then supplementation is going to be necessary, because the person might not be absorbing all their nutrients.Question: What are some of the most common misconceptions about supplements that you encounter?Answer: Some of the common misconceptions are, "This sounds like it will be helpful, I'm going to take it," and just willy-nilly picking things that sound like they might be helpful and that they've seen in a social media ad. Some other common misconceptions are not understanding that a lot of different supplements cross over each other. Before you know it you can be taking too much of something or depleting something else. I'll give you an example, during Covid there were a lot of people taking high doses of Zinc and Vitamin C and those are very well-intended supplements to use in a situation like that but using them long-term can cause problems because high doses of Zinc displaces Copper. Vitamin C in the form of Ascorbic Acid is a fragment of that nutrient. It's not food-based Vitamin C. So it takes other nutrients to be paired with it in order to metabolize it. So the takeaway is high dosing supplements like that long term can deplete the body of other nutrients.Question: What should people consider when selecting a supplement? Are there specific ingredients to look for or avoid?Answer: I like food-based supplements when it's possible, but it's not always possible to use a food-based supplement. Anytime you're trying to optimize supplementation, you want to try to start with the most natural form of that supplement, if that's available for that particular nutrient, because the body recognizes it much more easily. It's much more available to the body. It's easier to digest and absorb it. It has a lot less side effects. So we want to number one, get as close as we can to the natural food-based supplement, and also, select ones that are organic and third-party tested. A lot of times, I have folks bring in supplements all the time, and they have a lot of synthetic ingredients in them that may be appropriate in some situations, depending on what those are. But a lot of times, they are ingredients that can basically make the supplement worthless. I really do like food-based supplements. I want to make sure that they're organic. I also prefer third-party-tested supplements to ensure that an unbiased source confirms they contain exactly what's claimed, without any conflict of interest.Question: How can people verify the quality of a supplement before purchasing?Answer: The first thing I would say is only purchase supplements from people who are authorized to sell them. I'll use Amazon, as an example. Amazon is a great platform to buy things from that we all use, but they really can't regulate supplement distribution. I could fill my garage with expired Supplement XYZ and sell it on Amazon, and there's no regulation to stop me from filling those bottles with glucose pills or selling expired products. So, one of the first things I would say is, make sure that you buy them from a reputable place. I try to avoid grocery store supplements, even in health food stores and health food store brands, because that does not mean that they are healthy. I really recommend people work with someone who understands these concepts and can guide them in the right direction. Folks come in all the time taking things that are working well, and I'm glad that they are. However, sometimes you have no idea why, because there's not much to it. Other times, people are taking things that are loaded with hormones and antibiotics, because they may be animal-based products that have not been grass-fed or pasture-raised animal products. Or they could be plant-based products loaded with pesticides that are from genetically-modified food sources. I see that a lot too.Question: How can a person tell if a supplement is working or benefiting them?Answer: Well that's a really good question. With some supplements, patients may never see that they are working. It may be at the cellular level that we are working to accomplish a certain goal. Maybe we're trying to reduce oxidative stress or oxidative damage. Patients are not likely to feel that. You'll see it long term, if it creates a much cleaner metabolism and a much better environment for healthy aging. But will you always know that that's working? The only way to know that is by testing the parameters again to see. Now, with other supplements, people often times feel more energy. Patients may sleep better. They may feel less digestive issues, when they're digesting their food and absorbing the nutrients, which is always one of the first things that I test. There's very few always and nevers. But one of the always is, I always want to make sure that the gut can break down supplements and that you can absorb them. So a lot of times, people feel much better in those situations. Quality of life improves in day to day activities- their energy or mood or sleep quality is better. Other times, it's at the cellular level, and you might not know it right away but in time can see progress.Question: Can you explain the concept of "bioavailability" in supplements and why it matters?Answer: Bioavailability is basically, "When is that supplement, after you take it, available to the body?" Does that activity take place in the blood? Or does it not take place, until it shuttles into the cell or the innermost cell, which is the mitochondria. And that would vary based on what kind of supplement we're talking about. As an example, let's use something like Codliver Oil, which is an Omega-3 supplement. So when is it bioavailable? That has to go all the way to the cell. So, you can take a supplement like that, and there are co-factors that work with different supplements. Sometimes, you might take a supplement like Vitamin D. Well, that's shuttled into the cell by fat. So if someone is taking a Vitamin D supplement, and they're not taking an Omega supplement, if they were to need that, then there's nothing to take the Vitamin D into the cell. That's where bioavailability really varies between supplements. In summary, it means, "When is that supplement available to do what its intended purpose is in the body?"Question: Is this true: It's better sometimes to take certain supplements in the morning and others in the evening? Or does that not matter- you just take it at any time in the day?Answer: It really does matter. Let's say for example, that someone needs more protein or more B-Vitamins. Those are things that are really good to get into the body first thing in the morning, because it really supports the natural circadian rhythm of the body. You want to be at your highest energy levels in the morning with the rhythm of the sun coming up. So, all of those things are better, when we break our fast. However, there are other supplements that are much better to take in the afternoons. Also, there are a lot of supplements we want to dose twice a day - in some occasions even three times - but most common would be once or twice a day. We might need to put another dose of those nutrients in at lunch time, which is mimicking the natural eating rhythm of the body. Another example is that some supplements may be intended to help the body calm down when the sun sets. This helps you unwind and sleep. So, all of that plays into timing.Question: How do you advise clients on avoiding "over-supplementing" or taking too much of certain nutrients? Or is that a thing to worry about?Answer: Yea, that is a thing. I think it goes back to working with someone that knows what's in those supplements and can advise them. I see that all the time. Let's say someone picks up a supplement that's for hair loss. Those supplements are loaded with B-Vitamins. That person might already be on a multivitamin that's loaded with B-Vitamins, and those are shuttled into a pathway called the Methylation Pathway. You flood that with too many B-Vitamins, and this person is going to methylate too quickly, causing him or her to burn through neurotransmitters and hormones too fast. Another example is that I see people on B-12 a lot, which is a water soluble nutrient. However, their dosages could be so high that their kidneys really don't eliminate as much of it as we would want, especially if kidney function is compromised in some way. So, I think it's really good when folks don't add in things without checking with their provider to see if it's appropriate. Now, it's also important to note that on the other extreme of "over-supplementing", you have "under-supplementing". What I mean by this is that with some medications every patient should be on certain supplements. Every medication often has negative effects with certain nutrients. So for example, if someone's taking birth control pills, they should always take a multivitamin, because it depletes the body of B Vitamins. They can also contribute to things like leaky gut. So, doing things to support the gut and to support the nutrients that medications can take away is very important.Question: How can supplements support specific wellness goals, like immunity, energy or mental clarity?Answer: Supplements are great ways to support immunity. A lot of patients don't have stable immune responses. We see it when we do stool testing. We can see that immunity is compromised in the gut. If it's compromised in the gut, then we can potentially not have as robust an immune system as we would want. Same way with energy or mental clarity. With energy, often times, it's related to undiagnosed issues at the nutrient level or adrenal disfunction that has not been addressed. And with mental clarity, it goes back to nutrient deficiencies a lot of times too. Sometimes, it's related to medication side effects. So, how can supplements help with that? If you are deficient in an immune response - if you're deficient in energy - you don't have enough mental clarity, something's off, and if that's not identified and corrected, it's going to progress into something else later that you may never tie to that issue. For example, maybe you get Chronic Fatigue Syndrome, or you end up with Chronic Sinusitis that never gets really tied back to those initial symptoms. There are tons of things that we can do to support the immune system, depending on where the break down is. So, that can be in the form of low gut immunity. It can also be in the form of an autoimmune condition, which can lead to less stable immune responses. When this happens, your body can go from hypo-immune to hyper-immune. Another breakdown, or thing people struggle with, can be brain fog and inability to concentrate. This can be caused by an overload of toxins, hormone imbalances or neurotransmitter imbalances, and we can supplement at that imbalance and correct all of those issues.Question: What are some new or emerging trends in the supplement world that you're excited about?Answer: I'm excited about Peptides. I think Peptides can be really exciting. I'm excited about new research with Methylene Blue. Methylene Blue has been an industrial dye. It's been used in emergency rooms and emergency situations where there've been heavy toxic burdens on the body. There's a lot of new research that's coming out about it in the last year or so regarding treating patients or supporting patients with Alzheimer's and any kind of cognitive disfunction with depression or anxiety. It's also a very good antiviral, as well. So, those are two of the newest ones that I've introduced in the last year or two that I think can be very helpful, but you have to also be very careful with them. I wouldn't recommend using them without support, because it's easy to pick the wrong dose or pick the wrong Peptide.Question: What advice would you give to someone who's just starting to explore supplement options?Answer: I would start very slow and ideally work with someone that can guide you and do some testing. It was really ingrained in me to test, not guess. It's easy to think, "I'm feeling a certain way. I heard this works, and I'm going to try it." Not that there's anything wrong with that, but it's just not the best approach to get the outcome that you're looking for. The best approach is to test and look at what those might be, because something as vague as fatigue and brain fog can be manifested by so many different things. It's so much more effective to figure out what those are. Most functional medicine providers have that [test not guess] viewpoint ingrained in us, because that's really one of the things that sets functional medicine apart. Our profession listens for those nuances and complaints about what is bothering people. They are desperate for help, because no one's found a definitive diagnosis for their symptoms. A lot of times there isn't one, except that there's an imbalance. And we can identify those imbalances through testing and then correct them.Question: Are there any "staple" supplements you recommend for most people or for women vs. men, or does it really vary by individual?Answer: There are trends that I see. I feel like one of the biggest deficiencies that I see is the Omega index because that's where those fat soluble nutrients get shuttle-bused into the cell. And if you don't have enough of them, then you don't have enough shuttle-busses to take those fat-soluble nutrients where they need to go, which is the mitochondria. So, that is a huge one. I'd say 80% of patients tested have a low Omega index, which ideally should be at about 10%. Another one is Magnesium. I think that statistically about 70% of Americans are deficient in Magnesium. There's not enough Magnesium in our soils. We don't have nutrient-rich soils really anymore, and that's where a lot of our nutrient deficiencies come from. Minerals tend to be one of the most deficient nutrients that we see, and Magnesium is one of the most crucial ones that we see deficiency in. There's so many different forms of Magnesium. It's hard to just pick one and take it. There are Magnesiums that stay in the gut, while other Magnesiums help with motility. Additionally, there are Magnesiums that help with relaxation and are better at crossing the blood-brain barrier. So, it's hard to just pick one and take it. But if it's a gut issue and you're trying to improve motility, then you want to pick one that stays more in the bowel. And if it's something that's more relaxation needed or cognitive related, then you want to pick things like Magnesium Bisglysonate or Threonate that cross the blood-brain barrier and have more of a neurological impact.ClosingUltimately, supplements can be powerful tools to support health, but they work best when chosen thoughtfully and tailored to your unique needs. By understanding what’s missing from your diet, selecting high-quality options, and working with a trusted professional, you can harness the true benefits of supplementation. Remember, health is a journey, and with the right approach, supplements can be a valuable companion on your path to wellness.Takeaway #1Most of our diets are compromised in some way, whether it be through the types of foods we eat or the minerals lacking in our soils. Therefore, supplements are helpful and often needed, because they add-on nutrients that are missing from our diets.Takeaway #2There are trends in people being deficient in Omegas & Minerals (especially Magnesium). So, chances are most of us would benefit from taking an Omega/Fish Oil and Magnesium. However, there are various forms of Magnesium that benefit the body in different ways. So what type of Magnesium should we choose? This goes back to the importance of working with someone who can guide you based on your specific needs and test results.Takeaway #3 Not all supplements are created equal. I could get a Vitamin B supplement from the grocery store, and it might not be from a good source. Does it have synthetic material in it? Is it organic? Is it a reputable company that has been third party tested? What type of Vitamin B do I need... B-Complex or a B-12 Supplement? Is it animal-based? How many milligrams of it should I take? Should I take it in the morning or evening or with a certain type of food (ie. fat, protein, carb)? There's a lot that goes into choosing and taking supplements, but it doesn't have to be overwhelming. It's best to test, not guess. Working with a Functional Medicine Practitioner & Nutritionist, like Melissa Altman, who knows how to analyze test results and guide you with supplementation can take the stress of guess-work out of it and give you peace of mind that you're actually giving your body something that it needs.Final QuestionWhat if you could work with a professional that can take the time to listen, to know your story, and to analyze in-depth tests in order to get a complete picture of your health? What if you could boost your immunity, energy & mental clarity by taking supplements that fill in the gaps? Wouldn't you say, "Sign me up!?"Schedule a consultation with Melissa Altman today or check out her website here.She looks at a variety of health concerns including: gut imbalances, autoimmune disorders, nutritional deficiencies, food allergies, weight loss and more!