Quick answer: Food comes first, but some people benefit from supplements, especially when cutting out dairy and grains. Options to discuss with your provider include vitamin D if levels are low, omega-3s if you eat little fish, calcium if dietary intake is low, probiotics, fiber, collagen protein and a greens powder. Testing helps avoid guesswork, and supplements can interact with medications.
Key takeaways
A varied whole-food diet covers most nutrient needs, so supplements are meant to fill specific gaps.
Vitamin D, omega-3s and calcium are the main nutrients worth discussing, especially since dairy is excluded and many people rarely eat fatty fish.
Testing your levels first lets your provider read your results against the lab’s range and your overall picture.
Food first
A varied whole-food diet covers most needs. See micronutrients.
Supplements to consider
Vitamin D
Important for bones and immunity; test your level first.
Omega-3 fatty acids
Helpful if you rarely eat fatty fish.
Calcium
Dairy is excluded, so focus on greens, sardines and almonds; supplement only if intake is low.
Probiotics
May support digestion; fermented foods are a good first step.
Fiber
Vegetables, fruit, nuts and seeds usually provide enough; a supplement can help if not.
Collagen and greens
Collagen protein and greens powders are convenient options for some people.
How much?
The right amount depends on your diet, lab results and medications. Vitamin D is best dosed after a blood test, omega-3s are often used at 1 gram a day or less unless a clinician advises otherwise, and fiber supplements work best when started low and increased slowly with plenty of water.
Healthy aging lens
Nutrient testing with your provider helps personalize what you need as you age. See foods to eat.
When to see a naturopathic doctor
It may be time to see a naturopathic doctor if you have a chronic inflammatory, autoimmune or digestive condition, or if you have diabetes, kidney disease or take medications affected by diet changes. The same is true if you are pregnant, breastfeeding, or have a history of disordered eating, or if you want a plan tailored to your labs, symptoms and goals.
See a medical provider promptly for severe abdominal pain, signs of an allergic reaction such as swelling or trouble breathing, or fainting.
What the research shows
For vitamin D, a 2017 BMJ meta-analysis by Martineau and colleagues pooled 25 randomized trials with 11,321 people and found that vitamin D lowered the odds of acute respiratory infection by about 12% overall, with the largest benefit in people who started very low (below 25 nmol/L). Benefits were seen with daily or weekly dosing, not large occasional doses. The trials varied widely, so testing first remains the most useful step.
Probiotics are not one-size-fits-all. A 2018 meta-analysis by Ford and colleagues reviewed 53 randomized trials of probiotics in 5,545 adults with IBS. Some specific combinations and strains improved overall symptoms and abdominal pain, but the authors could not say which ones work best. Side effects were no more common than with placebo.
Omega-3 dose deserves attention. A 2021 meta-analysis by Gencer and colleagues of seven large trials with 81,210 people found a 25% higher risk of atrial fibrillation with marine omega-3 supplements, rising to 49% in trials using more than 1 gram a day. Most participants were older with heart risk factors, so this applies most to higher-dose use in that group.
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Questions to bring to your clinician
These questions can help you get the most out of your next visit.
Which of my nutrient levels would be worth testing before I add any supplements?
Could supplements alongside an anti-inflammatory diet interact with any of my current medications or other supplements?
Would any labs or health history details help us decide whether supplements alongside an anti-inflammatory diet makes sense for me?
How would we tell whether supplements alongside an anti-inflammatory diet is a good fit for me, and when should we check in again?
Frequently asked questions
Do I need supplements on this diet?
Not always; food comes first.
How do I get calcium without dairy?
Leafy greens, sardines with bones and almonds.
Should I take vitamin D?
Test first and discuss with your provider.
Can supplements interact with medications?
Yes. Check with your provider.
Sources
- Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 2017. PMID: 28202713. https://pubmed.ncbi.nlm.nih.gov/28202713/
- Ford AC, Harris LA, Lacy BE, et al. Systematic review with meta-analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome. Aliment Pharmacol Ther 2018. PMID: 30294792. https://pubmed.ncbi.nlm.nih.gov/30294792/
- Gencer B, Djousse L, Al-Ramady OT, et al. Effect of Long-Term Marine ɷ-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. Circulation 2021. PMID: 34612056. https://pubmed.ncbi.nlm.nih.gov/34612056/
- Aranow C. Vitamin D and the immune system. J Investig Med 2011. PMID: 21527855. https://pmc.ncbi.nlm.nih.gov/articles/PMC3166406/
- Swanson D, Block R, Mousa SA. Omega-3 fatty acids EPA and DHA: health benefits throughout life. Adv Nutr 2012. PMID: 22332096. https://pmc.ncbi.nlm.nih.gov/articles/PMC3262608/
- Asher GN, Corbett AH, Hawke RL. Common Herbal Dietary Supplement-Drug Interactions. Am Fam Physician 2017. PMID: 28762712. https://pubmed.ncbi.nlm.nih.gov/28762712/
- NIH ODS: Calcium
- NIH ODS: Omega-3 Fatty Acids
This article is for educational purposes only and is not medical advice. It does not replace an individual evaluation. Talk with your healthcare provider before starting supplements or changing medications, especially if you are pregnant, nursing, or managing a health condition.
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