Are You Taking the Right Supplements?

Discover what you need and what you don’t
By Michael A. Smith, MD

By far the most common questions I am asked have to do with what nutritional supplements to take and, equally important, what not to take. After all, there are a staggering number of choices out there—anyone who has walked into the supplement section of a natural foods store or conducted a quick online search on a vitamin supersite can attest to that.

To make things even more compli­cated, there are new products coming to market almost daily. It’s easy to get lost with all the options to consider.

So how do you know if you’re taking the right supplements? Should you add the latest Amazonian herb you just read about to your supplement regimen? What if you want to cut back a little to save money—which supplements should you keep and which ones should you pitch?

These are exactly the types of questions your supplement pyramid can answer for you.


You’re familiar with the food pyramid, right? It’s a graphic tool that helps you design and follow a healthy diet by telling you how many servings you should eat from different food groups. The supplement pyramid is like the food pyramid in that it’s an educa­tional graphic tool, but that’s where the similarities end.

Unlike its food counterpart, the supplement pyramid is personalized to meet your specific nutritional needs. After all, with the exception of a few foundational nutrients, there is no such thing as a one-size-fits-all supplement regimen. I think you’d agree that my needs are not yours and your needs are not mine.

Why a pyramid? The pyramid structure is symbolic of stability. As you ascend up the levels of the pyramid, the tiers shrink in size, representing their degree of importance to your health, so you’re going to build your supplement pyramid from the bottom up.


The Egyptian pyramids have lasted for over 4,000 years because of one thing—a solid foundation. Your supplement pyramid needs a sturdy base too. The supplements comprising this foundational level support basic life processes such as cellular energy production, growth, repair, and cellular regeneration.

No matter who you are or what you’re going through, you need the same foundational supplements as everybody else. You could think of them as the essential nutrients for living well as a human. They include four building blocks:

  1. A multivitamin/mineral that provides doses to optimize health.
  2. Omega-3 fatty acids that provide two grams every day from the source of your choice.
  3. Coenzyme Q10 (as ubiquinol) to enhance cell energy production.
  4. Probiotics to optimize all phases of digestion with healthy gut bacteria.


We all face different health challenges throughout our lives. Some of these you’ll have dealt with directly. You may have a history of heart disease, for example, or perhaps just some of the warning signs, like high blood pressure, elevated triglycerides, or insulin resis­tance.

Other health challenges may not have touched you yet, but they have affected members of your family, putting you at greater risk. Creating a personal as well as a family medical inventory will help you identify past, ongoing, and potential trouble spots for you to protect against.

You’ll note the known diseases as well as the strange symptoms that haven’t been diagnosed yet. Let’s say your older sister suffers from chronic hand tremors but her doctors don’t know why. This information would be included in your inventory as a potential nerve disorder and would require appropriate supple­mentation.

Using the list below, mark each of your personal and family medial issues and note the supplement suggestions to remedy them.

The Cardiovascular System

If you have heart and blood pressure problems, consider pomegranate extract or aged garlic extract.

The Nervous System

If you have poor brain function, nerve problems, and/or tremors, consider methylcobalamin (the active form of B12) or blueberry extract.

The Muscular System and Skin

If you have poor muscle strength, tone, and aches, consider branched-chain amino acids or propionyl-L-carnitine.

The Digestive System

If you have problems with your stomach and intestines, consider zinc-carnosine or artichoke extract.

The Immune System

If you have problems with your thymus, spleen, and lymph nodes, consider thymus extract or selenium.

The Skeletal System

If you have low bone density and painful joints, consider a dedicated bone formula providing calcium, vitamin D, and magnesium, or a dedicated joint formula providing glucosamine and hyaluronic acid.

The Respiratory System

If you have problems with your lungs, sinuses, and bronchial passages, consider N-acetyl cysteine (NAC) or Panax ginseng.

The Urinary System

If you have chronic kidney and bladder problems, consider cranberry extract or hibiscus extract.

Of course this medical inventory and subsequent supplement suggestions are far from complete. There are too many potential health issues to list in an inventory. Well, there is a solution—medical quizzes.

Sixteen medical quizzes have been developed on various body systems to provide another layer of detail beyond your inventory. By completing these quizzes, you’ll be able to pinpoint with more accuracy which supplements you really need. You can complete your quizzes online at


The top part of your supplement pyramid is the optimization level. Supplements in this level do exactly what the name implies. They don’t necessarily meet your medical needs—that’s what the personalization level is for. These supplements simply “optimize” your regimen.

This level is where you’ll find supplements that help you live a longer, healthier life. You could also think of them as age management supplements.

Here are what I believe to be the leading factors in aging and the supple­ments that can manage these factors or maybe even reverse them.

Restoring Hormones

The older we get, the fewer hormones we produce. It’s just a fact of life. Prominent doctors have long believed that this decline in hormone levels is a major reason why the human body ages from the cellular level on up. Start by getting a complete hormone panel. Follow this by replenishing the hormones you’re low in, like testosterone or progesterone.

Reducing Oxidative Stress

Oxidative stress is the strain on your body’s tissues when the free radicals in your system outnumber the antioxi­dants. It is widely believed to be a key contributor to the aging process.

While you can reduce your exposure by refusing to smoke, living in an unpol­luted area, wearing sunscreen, avoiding processed foods, and filtering your water, one of the key sources of free radicals is your own metabolism—so some free radicals are unavoidable.

So besides taking an ideally dosed multivitamin that provides some of the essential antioxidants, you might also consider an antioxidant formula made from plants and herbs.

Easing Chronic Inflammation

Inflammation is the common denomi­nator of all age-related disease—this is one of the main reasons I consider omega-3 oils to be foundational. But you might want to boost your intake of anti-inflammatory supplements like curcumin, black cumin seed, and ginger.

Preventing Glycation Reactions

Glycation is a process whereby sugars bond to proteins without the benefit of an enzyme to control the reaction. Proteins that have been glycated are known as advanced glycation end-products (or AGEs). These stiff and malformed mutant proteins have been linked with the development of a number of age-related diseases. Supple­ments such as vitamins B1 and B6 and a small protein called carnosine all can reduce glycation reactions.

Reversing Your Biological Clock

One of the best ways to see how fast your biological clock is ticking is to look at the length of your telomeres. “My what?” you may be asking. Yes, your telomeres. You may not have heard of them, but telomeres are the bits of DNA at the ends of your chromosomes. Think of them like the plastic caps at the ends of shoelaces: They’re supposed to keep your DNA from unraveling.

Every time one of your cells divides, your telomeres shorten. At a certain point, telomeres get too short to allow the cell to divide anymore, and the cell dies. Telomere length has been suggested to be a marker for biological aging. Consider resveratrol and red reishi mushroom extract to slow down the tick tock of your biological clock by preserving telomere length.


Hopefully you’re now well on your way to creating a personalized supplement pyramid—one uniquely tailored to your specific health needs and goals. First and foremost, build upon the foundational supplements, starting with a high-quality, ideally dosed multivitamin.

Working up, add omega-3 fish oils, ubiquinol (the active form of Co-Q10), and probiotics. These four supplements are foundational to your health as they help every cell and tissue throughout your body.

Once the foundation is in place, continue to work up the pyramid by completing the inventories and then the quizzes. As you see fit, add the suggested products into your pyramid in order of importance, moving from the bottom up. Lastly, consider the suggested products at the optimization level for counteracting the leading theories of aging.

And there you have it—a personalized and prioritized supplement regimen!


Michael A. Smith, MD, is a senior health scientist for Life Extension and the author of the newly released book, The Supplement Pyramid: How to Build Your Personalized Nutrition Regimen. To complement the book, Dr. Smith has created, featuring 16 interactive health quizzes and offering a host of health and wellness information.