A patient walks in taking eleven supplements. No clear plan. No idea which ones are helping.
My first move isn't to tell them to stop everything.
It's to find out what they're taking, why they started, and whether there's still a reason to continue.
I start with a supplement reconciliation, much like a medication review.
What is each product supposed to address? Who recommended it? What's the dose? How long have they been taking it? Are there overlapping ingredients, potential interactions, or safety concerns?
Then I look at the bigger clinical picture: their diagnoses, medications, lab work, symptoms, dietary intake, and health goals.
Safety comes first. Anything with a concerning interaction, excessive dose, or other meaningful risk needs prompt attention, ideally in coordination with their prescribing physician.
But stopping everything indiscriminately can be just as unhelpful as continuing everything without question. Some supplements may address a documented deficiency or a specific clinical need.
The goal isn't to eliminate supplements simply to make the list shorter.
It's to determine which ones are:
Clinically indicated and worth continuing
Potentially useful but in need of reassessment
Redundant, unsupported, or unnecessary
Potentially harmful or interacting with treatment
From there, we build a simpler, evidence-informed plan with clear priorities and a way to measure whether it's working.
Eleven supplements aren't necessarily the problem. Eleven supplements without a rationale, safety review, or follow-up plan are.
For physicians referring patients to nutrition support, this is an important part of my work: helping patients move from self-directed supplementation to a coordinated plan that supports their medical care.
