Supplement Safety Demystified
These days, it seems we are inundated with magazine articles, news stories, YouTube video’s, or blog posts promising improved memory, sustained energy, stronger immunity, dramatic weight loss, or improved sexual health, simply by ingesting a “new and improved” and “clinically proven” supplement. The story pulls you in with a testimonial from a seemingly trustworthy person who, like you, was “skeptical” at first, but then experienced such dramatic and “real” changes that they can’t imagine their life without the powerful and affordable product. Advertising at its best. Supplements can have a profound impact on one’s health, but there is so much misleading information available that it can be overwhelming and confusing. Indeed, here at The UltraWellness Center, we get a lot of questions about supplements, particularly whether or not they work and if the recommended brands are worth the expense.
Supplements are big business and research indicates that nearly two-thirds of Americans spend anywhere from 20 to 30 billion dollars per year on some form of dietary supplement. As a rule, we shop by price, and the bulk of supplements are purchased from mass-market merchandisers. Unfortunately most of our information about a supplement comes from the product packaging, as well as fake media promising miraculous results. Which begs the question, how do you know what to take, and how do you know if you’re getting what the label says? Efficacy aside, how can you be sure that what you are purchasing is even safe to take?
In 1994, Congress passed the Dietary Supplement Health and Education Act, which placed supplement regulation under food and not drugs. It also made it the responsibility of the supplement manufacturer to be in compliance with law. Whereas drug companies have to prove the safety and efficacy of a drug, with supplements the FDA bears the burden of proof that a supplement is unsafe or adulterated. Furthermore, unless there is a new dietary ingredient, supplement companies are not required by the FDA to provide any pre-market safety or efficacy documentation. While companies must comply with industry standards called Good Manufacturing Practices (GMP’s), a 2012 audit found that nearly 70% of companies audited by the FDA were not in compliance with major issues including failure to test products, the presence of contaminants, non-approved dietary ingredients, and pharmaceutical drugs
Purchasing supplements from companies that do not participate in third party testing can be risky business. Published research indicates the quality of ingredients varies widely from company to company. A JAMA article reported that many herbal supplements contain heavy metals such as lead, mercury, or arsenic. A study in the Annals of Internal Medicine, revealed one supplement to contain 200% more than the stated selenium content on the label, after an outbreak of selenium poisoning. While another study, evaluating the composition of 44 herbal products, found 32% contained none of the herbal ingredient listed on the label and 59% contained plant species that were not listed on the label at all. The New England Journal of Medicine reported that some dietary supplements contain banned ingredients as well as pharmaceutical drugs.
Fortunately, several agencies, including the National Sanitation Foundation (NSF) and the United States Pharmacopeia (USP), can provide product verification and product testing. The NSF, is an independently accredited laboratory, which conducts third-party testing to verify that the actual contents of the supplement product match those printed on the label. They also check to make sure the product is devoid of potentially harmful levels of impurities and that no unlisted ingredients are in the final product. The USP is a scientific, nonprofit organization that sets federally recognized public standards of quality for medicines, dietary supplements, and foods. Products with the “USP Verified Supplement” mark on the their label have undergone testing and auditing programs through USP. A label stating USP alone, means the manufacturer is claiming to adhere to the USP standard. A supplement that bears the NSF or USP stamp of verification has been through rigorous testing and consumers can be assured of product and ingredient safety.
Be wary of obscure brands purchased from Internet sales. While the FDA monitors supplement/ingredient imports (often from China and India), it does not have the capacity to check every shipment, nor has it been successful at removing banned products from Internet sales. To protect yourself, purchase supplements from reputable brands that bear the NSF of USP stamp.
In addition, there are several free sites where one can obtain credible information about supplements:
- Office of Dietary Supplements , where one will find factsheets, warnings, and recalls.
- You can also check the FDA Warning Letters database.
- The Linus Pauling Institute Micronutrient Research Center is a great resource for learning about nutrients and proper dosages.
- The National Center for Complementary and Integrative Health (NCCIH), is another helpful place to learn about supplements.
- PubMed, has clinical studies to back up, or reject, supplement health claims.
For the best supplement information, consult with an integrative and Functional Medicine physician or nutritionist. Here at the UltraWellness Clinic, we usually test patients before recommending supplements, and source our supplements from reputable brands that meet safe manufacturing practices. These products often come with a higher price, but for health and safety sake, it’s well worth it. Integrative and Functional Medicine is about determining the root cause of disease and supporting a patient’s health with lifestyle habits, a whole foods approach to eating, and supplement recommendations supported by laboratory testing.
The UltraWellness Center’s Top 5 supplements for general health*:
- Vitamin D3 – While your body can make this critical nutrient when exposed to sunlight, most people in northern latitudes lack sufficient exposure to make their own. Vitamin D is responsible for thousands of chemical reactions that take place in your body. It’s important for hormones, bone strength, cancer prevention, and the immune system. Never take more than 5,000 IU of vitamin D3 per day without a physician’s supervision and regular blood testing.
- Omega-3 Fatty Acids – These are essential for healthy metabolism. Their claim to fame is their anti-inflammatory capabilities, specifically in the prevention of heart disease and stroke. Omega-3 fatty acids may help control lupus, eczema, and rheumatoid arthritis, as well as other conditions.
- Magnesium- With depleted soil levels, this important mineral tends to be deficient in most individuals. Known as the calming mineral, more than 300 biochemical reactions require magnesium to be effective. The best forms to look for are glycinate and citrate.
- Multivitamins – Modern farms have mineral depleted soils and top-heavy applications of fertilizers, pesticides, and herbicides do little to allow the plant’s own natural defense system (think phytochemicals, antioxidants, vitamins) to develop. A high quality multivitamin can be a nice insurance policy. Avoid megavitamins, or dosing that is greater than 100% of the daily value.
- Probiotics – We know that a healthy gut can keep your whole body healthy. Taking a daily probiotic can help keep your microbiome in balance and your immune system strong. For general gut health, look for a broad spectrum probiotic that contains a variety of bacterial strains with 30-60 billion CFU.
*Keep in mind, that more is not better and use caution when dosing supplements so you do not exceed dosage limits.