Dr. Kevin Ritzenthaler, DC, DCBCN
If you’ve visited the vitamin and supplement aisle of your favorite store lately, you may have been overwhelmed by the myriad of choices available to you. As more and more people are using nutritional supplements to prevent or treat disease, the market for these products has exploded.
But how do you know which dietary supplements are right for you? And once you’ve determined what supplement you want to take, how do you know which brand to choose?
One key fact that everyone needs to know is that dietary supplements are NOT regulated by the FDA in the same way that drugs are. Most people are surprised to learn how little oversight there is in this industry. In fact, the FDA expects the supplement manufacturers to police themselves when it comes to the purity and quality of their products. (More on this later)
This presents a huge risk for consumers who are left to research these products on their own, and many would be wise to enlist the help of a health care professional when choosing nutritional supplements.
If you are researching supplements, the two most important things that you need to consider are the product’s preparation and quality.
First a little lesson from baking. If you’ve ever made cookies or muffins from scratch, you know that some recipes call for baking soda while others call for baking powder. And, if you’ve ever tried to substitute one for the other, you know it just doesn’t work. But why is that?
While both ingredients make your baked good rise, there is a distinct difference in the chemical reaction that takes place in order for each of them to work. Baking soda requires some sort of acid in order to become activated. Baking powder, on the other hand, has the activator built in. So, in order to know which to use in your recipe, you have to analyze all of the other ingredients and understand how they will interact with the baking soda or powder to get the desired result.
It’s the same way in our bodies. When adding a nutritional supplement to your diet, it’s important to understand the entire list of ingredients in the recipe.
• What is in the supplement?
• What role does each component play?
• How will the supplement interact with other supplements or medications that you take?
• How will that supplement interact with the overall chemistry of your body?
Here’s an example of the importance of the ratio of nutrients (or ingredients) in a particular supplement.
A few years ago, I had a patient come in who displayed all the signs and symptoms of copper deficiency, which is pretty rare. During his health history, he told me that he takes a multi-vitamin. Now I was intrigued, because someone who takes a multi-vitamin should have more than enough copper in their system not to have any problems. Copper is a trace mineral, meaning your body only requires a small amount of it.
I asked him to bring in his vitamin bottle so that I could look at it. The vitamins had come from a health food store, and he had spent good money on them. But when I analyzed the label, I saw that the supplement had high levels of zinc in it. Zinc and copper compete for the same absorption sites in your GI tract. The zinc levels were such that they prevented his body from being able to use the copper that was in the very same multi-vitamin! In fact, the levels were so high that they prevented him from absorbing any copper from his entire diet. So, it was his multi-vitamin that was making him ill.
In this case, two ingredients in the same pill were in conflict with one another. Now, imagine what could happen when you start to mix and match different supplements.
Nutrients Come in Different Forms
Another aspect of preparation has to do with the different forms of nutrients that make up a supplement. In many cases, there’s an inactive form of a vitamin and there’s an active form of the vitamin. For example, Vitamin D has three different forms: D1, D2, D3, – but only the D3 form is active. Likewise with folic acid – the form in most supplements is not the activated form that your body actually uses. The activated form is L-5-methyl-tetrahydrofolate, or L-5-methyl-THF. So if you take the folic acid that’s found in many vitamins, assuming that your body can actually get it in, absorb it, and utilize it – your body still has to activate it. And guess what? Our bodies don’t do that very well.
In the case of Vitamin E, there is a natural form and a synthetic form – you can probably guess which of these is better for you.
Why would a manufacturer choose a lesser form of a nutrient? In some cases, it comes down to cost and/or availability. In other cases, the lesser form may take up less room in the capsule or tablet.
As you can see, there are a lot of factors in how a supplement is prepared that will impact its effectiveness. Some supplements will do what you’re expecting, some might not do anything at all, and worst-case scenario: some can actually make you sick.
Dietary Supplement Quality and Purity
The second important aspect is the quality of the supplement.
As I mentioned at the beginning of this article, there’s very little regulation in the supplement industry. At the very least, that creates a situation where consumers are wasting their money on pills that don’t live up to their labeling. I’ve seen studies that claim anywhere from 25% to 75% of the supplements on the market are complete waste of money for one reason or another.
At the very worst, this lack of regulation can pose very serious health concerns.
Purity is of vital importance. You may be shocked to learn that it’s not uncommon to find contaminants in supplements. These can include mold, lead, mercury, pesticides, insecticides, and other toxic substances.
In many cases, what is listed on the label is not even what’s actually in the pill.
So how do you assess the quality and purity of a dietary supplement?
Manufacturing Standards for Nutritional Supplements
First, you should not rely on price as an indicator of quality. Marketers are smart. They know that consumers often equate price with quality. I’ve seen many high-priced supplements in very attractive packaging that do not meet even the minimum quality standards.
One baseline indicator of quality is whether the manufacturer follows the Good Manufacturing Practices (GMP) guidelines. These standards were put out by the FDA as a benchmark to help ensure the quality of dietary supplements. But you have to remember that the FDA doesn’t actually go back and test these supplements. Also, the GMPs for supplements are not as strict as the GMPs for drug manufacturing. In my opinion, this is the bare minimum level of safety.
Independent Lab Testing of Vitamins and Supplements
A reputable manufacturer will send their products to independent labs to test them for purity and quality. The best manufacturers may also enlist third-party inspectors to evaluate their production processes.
Since government regulation is lacking and there is no universally accepted seal of approval, it is up to you to look at the individual manufacturers and assess their quality standards.
If you’re taking a vitamin or supplement, you’re doing it to try to be healthier. But, as you can see, choosing the right supplement can be complex. There’s a science behind how the best supplements are prepared, and quality is not always easy to judge. Just because you can buy something over the counter, does not mean it is safe.
Your best bet is to enlist the help of a qualified health care professional with in-depth training in nutrition and supplementation. We cannot only help you to determine what supplements you should be taking, we can recommend a quality brand that you can trust.
Dr. Kevin Ritzenthaler, DC, DCBCN, is a Functional Medicine practitioner, diplomate in clinical nutrition, chiropractor, and owner of Innovative Health in Weston, Wisconsin. He can be reached at 715-355-4224 or via www.InnovativeHealthClinic.com. Initial consultations are always free of charge.