Paleo Diet: Essential Supplements?

Are supplements a good idea? Photo by Kittikun Atsawintarangkul, courtesy of

Earlier this week, I was laid low with a bug that has been doing the rounds at work.  A number of people have been off sick for several days with symptoms ranging from dizziness, nausea, lethargy, aches, pains, runny noses, stuffy heads, and a general feeling of having had their stuffing soundly thrashed out of them.

When it hit me, I began to resign myself to being out of action for several days.  Our Paleo Diet News colleague, Lila, had some advice for me on supplements: “Vitamin D!  Take a mega dose - 10,000 IU, once a day. You can go higher too. 50,000 to 200,000 IU are considered medicinal doses. Do this for 4 – 7 days.”  Lila knows her stuff, and I felt pretty rotten, so I didn’t take much persuading.

The result?  I had one day off work (most people had at least three) and felt dramatically better just a couple of days later.  Of course, all this is anecdotal - I can’t guarantee that the vitamin D is what did the trick, but I’m willing to bet it played a big part (and I’m pretty sure my paleo diet was a major factor, too).

It also set me off doing some research.  I wanted to know - for those on a paleo diet, is supplementation really necessary?   And if so, what should we be taking?

That’s what this article is about.  Let me be clear up front - I’m not medically qualified, so this isn’t in any way meant to be a prescription.  If you’re considering supplementation, it’s important that you do your own research, based on your own circumstances and needs.  Read, digest, and apply what you’ve learned.  Consider this a (hopefully) useful primer.

Is Supplementation Really Necessary?

Sensible supplementation can guard against disease. Photo by Graur Razvan Ionut, courtesy of

Ironically, it appears that many of us on the paleo diet took more supplements before we turned paleo than after.  Perhaps that’s not surprising, since we consider the paleo diet to be optimal.  But are we really relieved of the need for supplementation just because we’ve turned paleo?  Experts disagree, but my reading of the evidence suggests that this isn’t the case.

Lower overall caloric consumption (due to more sedentary lifestyles); consumption of fewer “whole” foods (our paleolithic ancestors ate the whole carcass of animals including liver and bone marrow); food production methods which favour volume over quality; cooking methods which discard nutrient-rich oils and broths; the presence of anti-nutrients in plant foods - these all conspire to make our modern diets (even modern “paleo” style diets) less nutritious than they could be.

Interestingly, there is evidence that even paleolithic humans, eating a high-nutrient diets, may have been malnourished.

A Wise Approach To Supplementation

It would seem, then, that supplementation would be wise, even for those with good paleo diets in place.  In my opinion, a wise approach to take would be:


  1. Adopt a high quality paleo diet.  Eat a wide variety of properly reared animal products, along with plenty of organic vegetables of all colours (this will maximise your complement of phytonutrients).  Eliminate all processed foods.  The key here is to make sure your diet is constructed of nutrient-dense foods including pastured animal fats (such as butter), whole eggs, organ meats (liver is a true “superfood”), bone broths, bone marrow, and fatty meats.  You could also include moderate amounts of high-antioxidant fruits, such as berries.
  2. Limit or eliminate your consumption of plant foods containing anti-nutrients. This includes grains, nuts, and legumes, and particularly soy. If you are going to eat these, ensure as many anti-nutrients as possible are reduced through soaking, sprouting, and fermenting.
  3. Make a good assessment of your nutritional profile.  You can do this by getting blood work done if necessary.  Then supplement based on your specific needs.
  4. When supplementing, favour whole food derived nutrients.  This means finding vitamins that are in the form that’s most digestible and absorbable by the human body.  Synthetic vitamins can cause imbalances as the body attempts to process them effectively.  For this reason, vitamin and mineral-rich superfoods should be included in the diet on a regular basis.  These include organ meats (or desiccated organ tablets if you really can’t stomach them); nutrient-dense and detoxifying algae such as spirulina and chlorella; and allergy-fighting bee pollen (in combination with propolis and royal jelly if wished).

The Key Paleo Supplements

Having taken a straw poll amongst Facebook friends in the International Paleo Movement and High Fat Friends groups, and having read some excellent articles on optimal paleo diet supplementation from enlightened experts Dr. Jack Kruse, Drs. Paul and Shou-Ching Jaminet, Dr John Briffa, and Dr. Russell Blaylock, I’ve compiled my own list of the supplements that we should all be paying heed to.

1. Probiotics

A good balance of gut flora is essential if nutrients are to be properly digested and absorbed, and a good balance of gut flora can be difficult to achieve in the modern world.  Food toxins and antibiotics have all waged war on the delicately balanced colonies of friendly bacteria that line our digestive tracts.  Good gut flora contribute to good immunity, too - so it pays to ensure we’re fortified in this area.  The best and most natural way is to eat lacto-fermented foods, but it’s also possible to supplement with an appropriate probiotic (make sure it contains multiple strains of lactobacillus and bifidobacterium).

2. A High Quality Multivitamin

Caution needs to be exercised in picking a multivitamin.  Supplementing with a multivitamin before a nutrient-dense diet is in place could be disastrous, as it leaves us open to imbalances (as described above).  In addition, many multivitamins contain an excessive ratio of vitamin A to vitamin D, and could theoretically contribute to vitamin A toxicity.

However, after a sound nutritional foundation is established through diet and supplementary superfoods, and vitamin D and K2 intake is optimized (see below), the balance of beneficial and toxic effects is likely to come down solidly in favour of being beneficial.  There are numerous studies highlighting the benefits of multivitamin intake. Dr. John Briffa highlights several in his blog - look here, here, and here.

Incidentally, he also provides a useful critique of a study which warned people off multivitamin consumption back in 2008.  You can read this here.

Pregnant and menstruating women should take a multivitamin containing iron, others should take one without.

3. Additional Vitamins D3 and K2

Sunlight is necessary for vitamin D synthesis - but do we get enough? Photo courtesy of Wikipedia.

It transpires that almost everyone should be taking supplementary vitamin D.  A pro-hormone, it’s crucial for good health, and deficiencies are a recognised causal factor in a host of serious diseases including heart disease, high blood pressure, arthritis, depression, cancer, autism, dementia, digestive distress, obesity, fibromyalgia, multiple sclerosis, and autoimmune disorders.

Supplementing with vitamin D is likely to pay great dividends for most people.  In supplementing with vitamin D, it’s best to go with the animal-derived variety (D3, or cholcalciferol) which is the kind human beings synthesize cholesterol into when skin is exposed to sunlight.  The plant-derived variety (D2, or ergocalciferol) is present in many supplements, and is less bio-available to humans.  Check the labels!

Interestingly, it’s possible that even those who regularly expose themselves to adequate sunlight may still require supplementation, and that the standard recommended supplementary dosage of 400 IU is woefully inadequate (up to 5000 IU is actually more likely to be beneficial).

Vitamin D3 supplementation should be accompanied by supplementation with vitamin K2.  There are two main reasons - firstly, K2 intake helps protect against (albeit unlikely) vitamin D toxicity, since the two act synergistically together; secondly, vitamin K2 deficiency is in itself widespread.  Supplementation with K2 appears to have significant benefits and was shown to reduce mortality by 26% in one ten-year study.  Vitamin K2 plays an essential role in guarding against the calcification (solidifying) of soft tissues, it strengthens bones, and helps prevent and defeat cancer. For complete research and information on the benefits of taking vitamin D visit the Vitamin D Council’s website.

4. Appropriate Essential Fatty Acids

Most people following a diet other than the paleo diet (and even some paleo dieters who haven’t sought out pastured animal products) will almost certainly have an imbalance of omega fatty acids in the blood.  The correct ratio of omega 3:6 should be between 1:1 and 1:3, but is - on average - 1:17 or much higher.

Cod liver oil has long been considered an essential supplement, as this advert for Moller's Cod Liver Oil shows. Click to enlarge. Photo courtesy of Wikipedia.

The very best way to redress the balance is to limit or avoid foods high in omega 6 oils (vegetable and seed oils, nuts, and non-ruminant animal meats) and to eat pastured animal products (including eggs) which will have a better balance of omega 3 and 6 within them.

In addition, regularly eat cold-water oily fish such as salmon and mackerel.  Some controversy exists in terms of supplementing with omega 3 rich fish oils, amidst fears that they may contribute to an inadequate balance of vitamins A and D, or may become rancid before consumption.

The Weston A Price Foundation provides a comprehensive resource outlining how to choose fish oil supplements, and which dosage to take.  At present, the smart money seems to be on taking modest amounts (around 1 or 2 g) of fermented cod liver oil in combination with high vitamin butter oil, since these act synergistically together and provide a wide variety of fat-soluble vitamins.

5. Appropriate Minerals

In addition to adequate vitamins (which are organic compounds manufactured within living animals) our bodies also require an appropriate balance of adequate minerals (which are inorganic compounds present in the earth).  The following are minerals which are commonly deficient amongst modern humans:

  • Selenium and Iodine - these combined guard against hypothyroidism and have powerful antioxidant effects
  • Magnesium - essential to the health of our enzymes and electrical communication between cells
  • Copper - essential to the health of the cardiovascular system

If possible, pick a good-quality multivitamin containing these minerals, or supplement separately.  The Jaminets provide recommended dosages on their blog.

6. Key antioxidants: Vitamin C and Coenzyme Q10

CoQ10 is heart-protective. Picture courtesy of Wikipedia.

Antioxidants protect against the damage caused by free radicals in the body.  In modern, hurried diets - particularly those that are low on raw foods - it can be difficult to consume an adequate amount.

Eat abundantly of fresh vegetables of varied hues, and a few portions per week of high-antioxidant fruits such as berries, and you’ll be doing your cells a great favour.  Supplementation is unlikely to hurt.  In terms of vitamin C, always choose naturally occurring vitamin C over synthesized ascorbic acid.  Dried acerola tablets are an excellent choice.

Coenzyme Q10 is a fat-soluble vitamin-like substance which is plays a critical role in the production of energy in our mitochondria.  Researchers have found that in many cases of heart disease, there is an associated deficiency of CoQ10.  Supplementation is likely to be beneficial, and many consider it essential for those who are taking statins, since these cholesterol-lowering drugs can create a significant CoQ10 deficiency.

7. Some Others To Consider: B Vitamins

Depending on who you read, the jury is out as to the benefits of taking supplementary B vitamins.  That’s if you’re on a paleo diet.  If you’re not, then deficiency is more likely, and supplementation may be beneficial.  In their book, The Perfect Health Diet, the Jaminets note:

The low toxicity of these vitamins means they are safe to supplement.  For healthy people, it is not necessary to supplement beyond a multivitamin, and any benefits would likely be undetectable.

On the other hand, Dr. Jack Kruze is a fan of extra B vitamins:

 In my view, you can not take enough B vitamins.  They are critical.  Always get your B12 level checked.  This is critical for optimal thyroid functioning.

He also heartily recommends supplementing with pyrroloquinoline quinone (PQQ) - a relatively recently discovered B vitamin - which he describes as “exercise in pill form” due to its contribution to mitochondrial health and fat-burning ability:

(PQQ) is probably the most important B vitamin when one is making the change from a sugar burning metabolism (SAD) to a fat burning furnace (paleo/primal).

We’ll keep you posted on the B vitamin story in a future Paleo Diet News article.  Until then - to your continued good health!
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Brian Cormack Carr is a life and career coach, charity CEO, writer, and advocate of a real foods diet.
His home on the web is where you will find more articles, his free Lifecrafting Newsletter, and information about his online career-creation programme
You can follow Brian on Twitter: @cormackcarr


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3 Responses to Paleo Diet: Essential Supplements?

  1. Jack Kruse October 1, 2011 at 8:30 am

    Here is the follow up on why B vitamins are critical. Many people don’t realize PQQ is a B vitamin and how it plays a massive role in turning on epigenetic signaling to make us a fat burner over a sugar burner. Once we understand the biology we can then make cogent arguments what makes sense and what does not.

    • Brian Cormack Carr October 1, 2011 at 10:20 am

      Thanks, Jack. Fascinating that PQQ is a relatively recent discovery amongst vitamins. I’ve heard some people call it B13. We may do an article on this one soon!

  2. paleo Diet Supplement December 11, 2011 at 10:28 am

    Thanks brian for such informative articles.
    Being a person from biological background i fee the vitamins are becoming the needs of body now.