The Weekly Healthspan Inquiry
Every week, a delaeMD physician answers a question from a patient or reader on anything related to healthspan medicine.
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- From
- Michael Leone, MD · delaeMD Clinical Care
- To
- Weekly Healthspan Inquiry subscribers
- Subject
- What supplements should I be taking as a healthy middle-aged adult?
Hi there,
Whenever a patient brings in a bag full of supplements, we evaluate the stack by looking at human physiology rather than marketing claims.
In clinical medicine, we ask two straightforward questions:
1. Is the goal correcting a shortfall, or pushing supraphysiologic levels?
Correcting an inadequacy (sensible): Your body requires micronutrients to operate within specific physiological ranges. When there is a documented deficiency (such as low ferritin, B12, or vitamin D) or an established risk-based need (like folic acid in pregnancy or B12 for strict vegans), targeted supplementation restores normal physiology.
Supraphysiologic mega dosing (usually counterproductive): The commercial supplement market relies on the assumption that if a normal level of a nutrient is good, taking 5x or 10x that amount must be better. Human biology doesn't work that way—nutrients have safe therapeutic windows with real upper limits. Pushing cellular pathways to unnaturally high levels can tax hepatic clearance, cause nutrient interactions, or even blunt normal physiological signals. A clear example: high-dose antioxidant vitamins (like vitamins C and E) taken around workouts can actually blunt the cellular stress signals your muscles need to adapt and build endurance.
2. Are we addressing a verified gap, or just guessing?
Most people start a daily supplement because an online symptom checklist resonated with them. But symptoms like fatigue or brain fog are notoriously nonspecific. Before committing to daily pills, it makes sense to confirm an actual need:
Check the biomarker first: For nutrients with validated, established lab cutoffs (such as 25-OH vitamin D, ferritin, or B12), let blood work guide the decision rather than assuming you are low.
Account for clear dietary gaps: Where lab markers are less practical, look at your actual diet. For instance, an Omega-3 supplement (EPA/DHA) is a reasonable way to bridge a dietary gap if you rarely eat fatty fish (even if it isn't a silver bullet for cardiovascular disease).
Treat subjective aids realistically: Things like magnesium for sleep or muscle recovery may offer mild symptomatic relief for some individuals, but they have modest clinical trial evidence and shouldn't be treated as universal requirements.
The bottom line: I'm not anti-supplement. When targeted to a documented deficiency, a specific life stage, or a clear dietary exclusion, they serve a precise clinical purpose. But they are meant to address specific shortfalls—not act as indiscriminate daily insurance policies or experimental megadoses. Identify your individual gaps with your doctor, dose with precision, and focus the rest of your effort on the medical baselines that actually move the needle.
Warmly,
Michael Leone, MD
Co-Founder & Clinical Lead, delaeMD