22. Pharmaceuticals vs. Supplements: What Your Doctor Isn't Telling You

If you've ever stood in the supplement aisle wondering whether any of it actually works, or sat across from a doctor who handed you a prescription without explaining why, this conversation is for you.

The question of pharmaceuticals versus supplements comes up constantly in functional medicine, and the honest answer is more nuanced than most people expect. In this episode, Dr. Mark Su breaks down the real-world comparison between prescription medications and natural supplements, not from a place of dogma, but from years of clinical experience working with patients who are navigating both worlds at the same time.

What You'll Learn in This Episode:

• Why pharmaceuticals often offer more predictability in the short term, and what that actually means for your treatment plan.
• Why treating a single condition with supplements frequently requires multiple products and higher pill counts than most people anticipate.
• How the cost and practicality of a supplement protocol can quietly become its own barrier to healing.
• What "polypharmacy" means, why it applies to supplement stacks just as much as prescriptions, and why it matters for chronic illness patients.
• How Dr. Mark approaches the pharma versus non-pharma decision for individual patients, and why there is no one-size-fits-all answer.

About Dr. Mark Su:

Dr. Mark Su is an integrative and functional medicine physician and the founder of RootSeek Health. He works with patients who have spent years searching for answers to complex chronic illness, and he built his practice around the belief that real healing starts with finding the root cause, not just managing symptoms. His approach draws from both conventional and natural medicine, using whatever tools best serve each patient.

Key Insights:

One of the most practical realities Dr. Mark addresses in this episode is pill burden. When a patient chooses a supplement-based approach for a condition like high blood pressure, they may need two or three different products, often at multiple doses per day, to match the effect of a single pharmaceutical. That's not a reason to dismiss supplements. It's simply information that helps patients make informed, realistic decisions about their own care.

What makes this episode stand out is Dr. Mark's refusal to take sides. He genuinely believes in the best of both worlds, and he walks through the real clinical reasoning behind how he helps patients choose, adjust, and consolidate their treatment plans over time.

Connect With Dr. Mark Su: 

Website: https://rootseekhealth.com/ 

Need help with your Labs? 

 rootseekhealth.com/labs 

Instagram: @rootseekhealth

Subscribe and Leave a Review: If this episode gave you something to think about, it would mean a lot if you shared it with someone who's navigating these same decisions, and a quick review goes a long way in helping more people find the show.

Disclaimer: This podcast is for educational purposes only.  Information discussed is not intended for diagnosis, curing, or prevention of any disease and is not intended to replace advice given by a licensed healthcare practitioner. This podcast and its guests may have direct or indirect financial interests associated with products mentioned.

Transcript

Welcome And The Podcast Promise

Dr. Mark Su 0:09

I'm Dr. Mark Sue and welcome to the Functional Medicine Reality Podcast. Join me and our community weekly as we bring you unfiltered health from inflammation to longevity. Real stories, real people, real solutions. Experience real life health changes from both patients and practitioners. And learn how to turn cutting-edge information into real results in your own life so you can feel better, live longer, live healthier, and be confident and clear in your healthcare choices. Let's get real and get results.

Pharma Vs Non-Pharma Framing

Dr. Mark Su 0:41

Hey friends, here's one today for you that falls into the category again of talking about comparisons and contrasts between prescriptions and non-prescriptions, all right? Pharma and non-pharma. As you may know, I'm open-minded with all the tools I have. The best of both worlds is the way I go. I am not a practitioner based on dogma on principle alone. There's no perfect world on either side, is the way I look at it, all right? I am up for supporting my patients however they best prefer if it comes to a philosophy. Otherwise, commonly it's what is going to be the best fit for the patient. And that is the question I get from a lot of patients is given that I have options in both worlds, what should I do? What do you recommend for me? Skipping the question, skipping the direct response to that, because it's not always that straightforward.

Predictability Of Prescription Outcomes

Dr. Mark Su 1:25

Let's take blood pressure for an example, all right? Treating blood pressure or treating low mood, all right, those are two easy examples for me. The differences are the following. Number one, when it comes to pharmaceuticals, we just have, in my opinion, in my experience, we just have more predictability as to how what the outcomes are gonna be. All right. If I'm trying to get blood pressure down, I can say with more confidence and more predictability how far I'm gonna get with what any given medication. Now, I admit a lot of that is just I've seen a lot more patients be treated with prescription medications for blood pressure than I have with non-pharma options of whatever sort. And that's part of the problem is that there's so many options in this pharmaceutical world that the sample number, if you will, the number of observations I've had with patients who are on supplement X or supplement Y for blood pressure, the numbers are just less because there's the volume of data points is diluted by how many options

Why Supplements Often Mean More Pills

Dr. Mark Su 2:18

there are. The second piece of that, however, is that I often will counsel patients that if you're looking to treat some the same topic with non-pharma options, I'm all in in support of that. Yet you're likely going to have to expect to take multiple treatments, multiple products for the same condition. Okay. And so then it becomes a matter of pragmatics and cost. If I can get a person's blood pressure down with one pharma medication, all right, and I know I'm bypassing the whole topic about eating and exercise and everything else, all right. I'm going straight into just if we are just right lasering in on taking pills, and it comes down to pharma or non-pharma, when it comes to blood pressure, one medication, especially if we're jumping past the first dose or two, because I'm not gun shy to skip past the first dose or two. There's only two or three medications in the conventional world that I am a stickler on starting low and going slow. That's the phrase we learn we are taught many times in medical school and residency: start low, go slow. I just find we're wasting our time for most people. There are some exceptions, but generally speaking, there's only two or three medications where I'm gonna take it slow because people do not do going too fast, all right? But especially when it comes to blood pressure, I can jump past the first dosing, maybe even the second dosing, depending on how high the person's pressures are. And we can predictably see the numbers come down within a relatively short amount of time, right? It could be within days, it could be within a couple weeks. But if I'm gonna offer or support somebody in using non-pharmaceutical options to treat blood pressure, I'm telling them you're likely gonna need two, maybe three different supplements to get that down. And each of those supplements, I should say, get that down to the same degree as the single pharmaceutical option. Okay. And within each of those supplements, those supplement products, you're likely almost definitely gonna need more than one of each of those products. So if I'm using three different supplements to get blood pressure down to the same degree as that one blood pressure pill in the pharma world, but those three products, I need two of each in a given day. We might be talking about six pills in a day versus one pharmaceutical, all right? Now, I'm not putting any value judgments or value assessments on pharma versus non-pharma here. If I'm looking at them as equal playing fields, because I like to take I like to have my toolbox wide open and take the best of both worlds, all right? There neither are perfect ideal candidates. There's pros and cons to everything. One of the cons with the supplements here is that usually people are going to need more pills to substitute out or to match the efficacy of a given pharmaceutical single pill. And hey, if a patient's willing to do that, fantastic. I'm in total support. But it is not uncommon that over time, if we're if we are having to apply that principle or a patient has that experience with one topic here, blood pressure, and they're taking, let's say, four supplements, uh, pills in a day, maybe it's two pills a day of two different products to match the benefit

Low Mood Example With St John’s Wort

Dr. Mark Su 5:17

of one pharmaceutical pill, they may tolerate that. But now we throw in that the person has low mood and they don't want to prescribe they don't want a prescription for that either, which I'm totally cool with, all right. Arguments aside about the benefits or pros and cons and such about prescription medications for mood. But let's say we go the road of non-pharma, and again, if we are gonna stack 5HTP with St. John's wart, let's say commonly the dosing for St. John's wart is 300 milligrams a capsule. And people, by research, they often need a minimum of three a day at 900 milligrams. The research often is into 1500 milligrams or sometimes more. So now we're stacking another, let's say, four or five pills between 5 HTP and St. John's wart to match the single SSRI. And I know there's people who don't like the SSRIs, so let's put that aside for a second. But now between blood pressure and mood, we're talking eight, maybe nine pills in the non-pharma world compared to say one of each in the pharma world, nine versus two. It's just the it's the pragmatics of how many pills we're taking in a day. And then there's also the cost. So you can see how both add up the number of pills, the cost, and again, in an ideal world, I would love to be able to use, I would love more people to choose non-pharma for not a lot of reasons, and some topics and some case for some topics and conditions more so than others, all right. I have a more of a want for the non-pharma, all right. And I really definitely don't love the the long-term pharma for whatever a case may be, okay. Overall, if we had better, if we had equivalent options in cost and in efficacy or even a better efficacy with the supplements where we can use fewer

Cost And The Reality Of Pill Burden

Dr. Mark Su 6:55

supplements to equal this a single pharmaceutical pill, I would love to have even more confidence or have more advocacy for the non-pharma world. But it's a common experience by patients that over time they are facing a dilemma of in the medical world we call it polypharmacy, too many pills. Absolutely, that's a problem. Absolutely. Too many prescriptions, too many pills. But the same thing happens on some level with supplements, right? What do we call it? Do we call it poly supplement pharmacy, poly naturopathy? I don't know what to call it, but but yeah, patients are all the time weeding and reassessing, trying to consolidate their number of supplements they're taking for a variety of conditions, right? And trying to pick and choose which ones are of greater priority than others is a pretty tall order many times, especially when the patient's chronically ill. All right. Bottom line, comparison and contrast with pill pharma and non-pharma, aside from the values of principle of preference and other philosophical dogma topics. Many times from my experience, it comes down to how many pills and at what cost is the patient willing to tolerate to use non-pharma compared to pharma

Bottom Line And Closing Thoughts

Dr. Mark Su 8:07

and all that outside of lifestyle management options and such, which we'll save that for another time. But that, my friends, is a definite reality that I observe and face in the functional and conventional world intersect in the modern day, current day America as we know it. So fresh, just the way you like it.