Read to me!!
Since your brain injury, how many different health providers have you seen? Probably a number of doctors and maybe a neurologist. Maybe a massage therapist, physiotherapist, psychologist. Even chiropractors or neuro-optometrists. And hopefully an occupational therapist somewhere in there too!
By the time most of my clients have found their way to me, they’ve already seen most everybody else. And don’t get me wrong, there’s no one therapy that is necessarily better than any other — it all depends on the person as all can be valuable and contribute a lot to a person’s recovery.
It’s just that food is something you have every day that can either help or hinder your recovery. Yet most health teams don’t include nor refer to a dietitian for nutrition therapy.
Most of my clients come to me already taking a very long list of supplements they received from one or more of their other providers.
However, my clients received this list without any guidance, education or further follow-up on these supplements. And when asked, my clients generally can’t tell me why they are taking the supplements they are, what issue the supplements are targeting, and when they should stop taking those supplements…
It’s quite possible that some of these supplements have been helpful. And it’s also possible that these supplements are causing problems.
For the most part, TBI survivors I meet don’t want to take more pills or powders. And a long list of supplements can cost hundreds of dollars each month.
On top of that, supplements can’t fully capture all the health benefits you get from food.
If you’ve been given a long list of supplements, or are thinking about taking some supplements for your recovery, then this article is for YOU!
Supplements definitely have a place in TBI recovery. So just like I do with my clients, I want to help you target specific supplements and get most of what you need through food, so that you’re not wasting money and having to remember to take a bunch of pills everyday unnecessarily.
Does this sound like something you want?
If so, then here are my top tips for deciding if that long list of supplements is actually for you, and how to shift towards food.
#1 Do you know your baseline?
One of my jobs as your brain injury dietitian is to really understand and assess what food is like in your life:
- Your capacity to meal plan, grocery shop, and cook
- What your meal timing is like
- Your beliefs around food and your food culture
- How much you have been able to eat
- Physiologic problems that make eating difficulty for you, like low appetite or gut issues
- Any food and medication interactions you may have
- Your daily, weekly, monthly food intake patterns, nutrient deficiencies and excesses
- Etc…
Now tell me. The people who most often have provided you a long list of supplements, have they asked you these questions? Have they dug deep into assessing your nutrition status?
Nutrition is complicated. That is why there is a whole profession dedicated to it!
Outside of nutrition-focused fields, providers generally are not trained to do this kind of assessment. Just like I’m not trained in their complicated fields!
One of my clients who came to me with a long list of supplements had no idea why they were taking them. They were simply given the list once by their neuro-optometrist and received no further follow-up or guidance on the supplements.
I can for sure say that I don’t have the training, knowledge, or ability to prescribe different eye-glass lenses. So I’m perplexed why a neuro-optometrist would provide a long list of nutritional supplements without any follow-up, when there are a number of issues that can come from this.
(more on how this list caused problems for my client later)
Let me be clear: there’s always going to be some cross-over between the work of health providers. I as a dietitian am NOT the gatekeeper of all things nutrition nor supplements.
But for you to get the most from nutrition advice, consider this:
Tip #1: A nutrition assessment is needed. Without a detailed food recall, looking at your medical history, understanding how you’re able to plan, make and eat food, plus some lab work, we can’t know what you may be deficient in, and what we can add with as few side effects as possible.
#2 Do you have gut problems?
All nutritional supplements have side effects.
Yep. It’s true.
Some of these may be quite rare or depend on the quality of the supplement.
For others, side effects can be as bad as some medications (for example, melatonin vs amitriptyline).
And other side effects may be because of interactions with some of your medications or other health issues (for example, some supplements contribute to blood thinning and so may be an issue with blood thinners or before invasive surgeries).
But perhaps the most common side effects relate to your gut.
A lot of people I meet and work with in our TBI/ post-concussion community have some sort of digestive issue. For myself, my digestive issues actually acted up a couple of years into my recovery!
We know there’s a gut-brain connection and that when one is off, the other is likely affected. Many people who don’t have the bigger & more complex picture of nutrition may use this gut-brain connection fact to promote supplements…
Well… that’s very short-sighted.
In fact, that long list of supplements all at once is bound to cause some stomach upset, if not aggravate the gut issues you already have. Because it’s likely all those supplements can’t fully be absorbed, and some may just be hard on your gut or require specific timing.
This happened to that client of mine who was taking a plethora of supplements on the advice of their neuro-optometrist.
Don’t get me wrong — I don’t have it out for neuro-optometrists! The glasses that neuro-optometrist prescribed my client made a world of difference for their symptoms!
But my client couldn’t understand why they were having so much stomach upset (which lead to some unpleasant poop problems, if you know what I mean. And hey, I know you do. We’ve all been there 😉).
Cleaning up my client’s supplement list and changing the form of their magnesium was what it took totally solve this client’s gut problems.
Tip #2: Your supplement plan needs to take into account how the rest of your body is working. Ideally, do one supplement at a time while working on increasing nutritious foods in your diet. We do this so that hopefully you won’t always have to rely on a supplement if it’s not needed.
#3 Does the nutrient in question target a specific problem you are having?
In general, trialling supplements one at a time is the best way to go and here’s why:
- if the supplement causes any side effects, you’ll know exactly which one is the culprit
- If the supplement is working then you’ll know which one is helpful
- This approach is much better on your bank account, preventing your from wasting money on things that don’t help or even cause problems
So then, how to choose which supplement to start with?
When I work with my clients, we’re matching supplement to symptom. We base this off of blood work and a nutrition assessment. Then we prioritize what is the main symptom causing the most problems. From there we can trial therapeutic doses or look at food sources of specific nutrients that are related to the deficiencies and main symptoms. For example:
- Cognitive issues? —> maybe an omega-3 would be a good place to start
- Fatigue? —> creatine might be worth a shot
- Pain? —> magnesium through food or supplement
- Lethargy? —> checking blood work for iron, B12, Vit D at least, then supplementing to correct deficiency
This is a much better way to work that’s more tailored and targeted to you.
Tip #3: Don’t throw a bunch of darts hoping one will hit the bulls-eye. Being strategic about your supplements let’s you know exactly what’s working and what’s not, while saving you money and actually working to solve your biggest problems.
Are supplements for you?
Depending on where you’re at in your recovery, shifting towards getting most of your nutrition through food may not be the legitimate quick fix you need.
Indeed, if the brain injury is causing low appetite, nausea, vomiting, or any other challenges that prevent you from eating at least three times a day, then some form of supplement is needed to just cover your bases. Whether that’s a simple multivitamin until we can get you eating enough, or a “meal replacement” type nutrition supplement until we can get you eating at all!!
Supplements do have their time and place as a source of support while we work on making eating food a reality for you.
And I am always here as a source of support too!
If you want to clean up your supplement list, shift towards food, and be strategic targeting supplement to symptom, then set up a Tele-Help call with me.
There’s no cost for this first call. We’ll have a calm conversation about what you’ve tired and if working with me to do the above is a good fit for both of us.
You can book that call right here:
Best in brain health,
Krystal Merrells,
Your TBI dietitian