Build a personalized supplement stack in three easy steps

Tips for choosing supplements, trusted brands and how to measure efficacy.

Carol Bove, Drizzling Kiln 2023

Open Instagram, and you'll be bombarded with ads for supplements, both from direct-to-consumer brands and wellness influencers who are paid to promote them. Nearly everyone offers a 'miracle' supplement, promising to cure any ailment—from bloating to hair loss—or, in some cases, to fix ALL your problems with just a single scoop. As their name suggests, supplements cannot truly fix any health issue on their own. However, when chosen correctly, they can 'supplement' your diet and lifestyle, bringing you into the optimal range for a number of biomarkers

I’ve been taking supplements for over ten years and have seen significant improvements in certain aspects of my health. From this process I’ve learned that building a supplement stack that works requires focusing on three criteria: testing (understanding the reasons behind taking a specific supplement), quality and efficacy (validating that a supplement works as intended through tracking).

Before I break each of these down in more detail, one word of caution regarding supplements that promise to give you ‘everything you need’ in a single capsule or scoop. A lengthy list of ingredients might give the impression of comprehensiveness, but this is where paying attention to labels really matters. It’s not solely about the quality of ingredients but also their appropriate dosages. Many multivitamins or all-in-one supplements contain only minimal amounts of the micronutrients you need. While these are unlikely to be harmful, they could ultimately be a waste of money. For instance, Vitamin D and Omega-3 fatty acids are far more effective at higher daily doses (5,000 IUs and 2 grams, respectively) than what is typically found in popular brands. The same principle applies to probiotics; effectiveness requires billions of colony-forming units (CFUs) per day and multiple clinically-proven strains, significantly more than what is usually present in a multivitamin product.

1. Testing

Understanding why you are taking a supplement is the first and most crucial step in building your supplement stack. For example, you might see an ad for a supplement claiming to enhance energy and focus, tempting you to buy it. However, without prior testing (bloodwork), you wouldn't know the actual cause of your lack of energy or focus. It could be due to a deficiency in B vitamins, low iron levels, or a sluggish thyroid. This principle also applies to other common health issues, like bloating, for which countless supplements are marketed daily. If you're experiencing bloating, it's essential to identify the root cause before choosing a supplement. Without understanding what's causing your symptoms, it's impossible to know whether you need a probiotic, a digestive enzyme, or a more specific treatment.

I wrote an in-depth guide to blood testing for women's health that you can read here, but as a brief reminder, here are some of the biomarkers that I test every year based on which I update my supplement protocol:

1. CBC - Red and white blood cell counts

2. Comprehensive Metabolic Panel to assess kidney and liver health (including GGTP, AST, ALT, Albumin and electrolytes)

3. Comprehensive Lipid Panel (Total cholesterol, LDL, HDL, Triglycerides) and importantly, Apo-B and Lpa.

4. Inflammation markers (hsCRP, ESR, Homocysteine)

5. Micronutrients including: Vitamin D3 (as Vitamin D, 0H-25) Vitamin B12, Folate, Magnesium, Selenium, Zinc, Copper, Ferritin, Iron

6. Blood sugar markers (Fasting glucose, Fasting insulin, Hemoglobin A1C)

7. Full thyroid panel including THS, Free T3, Free T4, and Thyroid autoimmune antibodies (TPO)

8. Metals (toxicity): Mercury, Lead

9. Sex hormones: Free and Total Testosterone, DHEA-S, Estrogen and Estrogen metabolites, Progesterone, LH

10. Routine Urinalysis

2. Quality

In the US, unlike prescription and over-the-counter drugs, the FDA does not require dietary supplements to be proven safe or effective before they are marketed. Instead, the responsibility for ensuring the safety and labeling of their products lies with the manufacturers and distributors before they reach the consumer. The FDA regulates the labeling of dietary supplements, including health claims, nutrient content claims, and structure/function claims. However, while manufacturers are required to submit evidence supporting their claims, they do not need FDA approval before marketing their products with these claims.

To make sure that the supplements you take are efficacious and of high quality, I recommend doing the following:

• Look for scientific evidence supporting the efficacy of the supplement for its intended use. Scholarly articles, clinical studies, and reputable health information websites can be good sources of information. Be wary of supplements that claim to cure a wide range of unrelated health issues, as these are likely to be too good to be true.

• Look for supplements that have been tested by reputable third-party organizations such as U.S. Pharmacopeia (USP), ConsumerLab, or NSF International. These organizations test supplements to verify that they contain the ingredients listed on the label, without contaminants, and are manufactured in a safe and sanitary environment.

My go-to place for buying supplements is Fullscript. They are a practitioner-driven platform for prescribing supplements that only stocks third-party lab tested brands. Some of the brands I have been taking over the years include:

• Pure Encapsulations

• Metagenics

• Designs for Health

• Ortho Molecular

• Klaire Labs

• Apex Energetics

• Thorne

• Pendulum

3. Efficacy

The third step in building a personalized supplement stack is understanding whether a specific supplement is working for you. To do that, I recommend introducing only one or two new supplements at a time and giving each at least four to six weeks to assess the results. It’s also useful to track your symptoms to see whether they’re improving and repeat bloodwork or specialty testing quarterly to check if supplements are making an impact on your biomarkers. Below is an example of how I track of all my supplements in a spreadsheet that I update every couple of months.

Finally, while supplements need to be highly personalized and targeted at specific needs, there are a few that most people will likely benefit from as these deficiencies are increasingly common:

• Magnesium (I like a combination of citrate and glycinate or l-threonate) - 200-400 mg daily

• Vitamin D3/K2 (K2 helps your body absorb calcium) - 5000 IUs daily

• Omega-3 (containing both EPA and DHA) - 2 grams daily

• B vitamin complex ( I prefer a methylated version for better absorption)

• A quality multivitamin to cover some of the basics but you will still likely need to supplement with all of the above.

• If you’re a woman, iron is another important one that you might need.

If you need more tips or recommendations for choosing supplements, feel free to email or DM me and I’ll be happy to help.