-How to distinguish quality products from inferior products.
-How to ensure safety in dosage and use.
-A few strategies you can use to maximize benefits.
-Some general recommendations
First: How to distinguish quality from inferior products:
In 1994 the FDA passed the DSHEA (Dietary Supplement Health and Education Act. It laid the responsibility for the products safety on the shoulders of the manufactures, and left as well the responsibility of screening and testing on the companies as well. As long as no one is watching, many companies would just as well not do the testing, or put out inferior products knowing there would be no repercussions for it. From he FDA website:
“the dietary supplement or dietary ingredient manufacturer is responsible for ensuring that a dietary supplement or ingredient is safe before it is marketed. FDA is responsible for taking action against any unsafe dietary supplement product after it reaches the market. Generally, manufacturers do not need to register their products with FDA nor get FDA approval before producing or selling dietary supplements.”
This means that it is up to use to police these supplements. There are a lot of ways that manufacturers can create inferior products. The first thing to understand is that there are a lot of possible ingredients in a supplement besides just the ingredient you are looking for. Let’s say your taking milk thistle for liver health. Well, there may be much more than just milk thistle in your supplement. Here’s a picture of the typical anatomy of a supplement:
As you can see there is much more going on here than just the main ingredient. In a lot of cases these other ingredients may be causing serious harm in your future, while you think you are taking care of your health. Here’s a look at some of the most dangerous additives to supplements:
Parabens: Common preservative material, have estrogen like activity in the body affecting both men and women:
-Methyparaben
-Ethylparaben
-Polyparaben
-Butylparaben
Pthalates: Used as a plasticizer. Estrogen like material that will stimulate our receptors. Resulting in infertility, sexual dysfunction, and increase risk of cancer.
-Benzylbutylpthalate
-Di2ethylhexylpthalate
-Diisodecylpthalate
Notice that “paraben” or “pthalate” is only at the end of the ingredient name, without knowing this, you might well pass right over the ingredient name as you scan through.
Titanium Dioxide is another interesting additive. In it’s natural form it is pretty benign. But much of the titanium dioxide is in the form of superfine particles, or nanoparticles. These have been found to cause some pretty significant health issues. Here’s Christopher Chang from the May, 2010 issue of the “Journal of Autoimmunity.”
“Nanomedicine has already opened up a new avenue of research in cancer therapy, drug delivery, and immune regulation. While the benefits of this new science to human civilization are seemingly immeasurable, it is also important to appreciate that these particles can also lead to harmful effects on human health.”
-and again:
“Increased mutation frequency has also been described in cultured human lymphoblastoid cells exposed to ultrafine TiO2 particles. TiO2 nanoparticles have been shown to be cytotoxic in mouse fibroblast cells...”
And a paper out of the UCLA research laboratories found that titanium dioxide damages cells and the genetic level.
Artificial colors are another issue. Many studies have shown that artificial colors contribute to, or exacerbate the symptoms of autism, ADHD, and other behavioral disorders. The artificial colorings are usually found as either “lakes” or “dyes” the difference is that the lakes are the fat soluble forms of coloring and the dyes are those used for water soluble applications. Fat soluble toxins are more damaging than water soluble toxins, because they detoxify from our bodies differently and likely will be present for longer in our tissues that water soluble. If you have to chose between a product containing “lakes” and another containing “dyes,” I’d recommend the dyes. But there are many natural ingredients that can be used for color, including caramel, beet juice, and beta carotene, so in truth there is no need for any artificial dyes or colorings in our supplements.
Magnesium Stearate: is an excipient that is often added to supplements for a few reasons. First it provides bulking so that it can fill out a supplement to a larger size if that is something that makes taking the supplement more convenient. Second it is added to help lubricate the machines. As the tablets or powder moves through the processing and manufacture machinery it is likely to cause binding, slowing, or may stick to the machines. Magnesium stearate is a fatty acid (stearic acid) bound to magnesium and as a result it’s presence in supplements results in less physical friction in processing. In and of itself it is already present in our diet. However its presence does decrease the speed at which supplements break down, and if it is used in excess in supplements then it can decrease our absorption of the ingredients. My recommendation would be to consider it a necessary evil in some brands, and to not necessarily exclude a product by virtue of seeing magnesium stearate on the ingredients, but rather to look for where it appears on the ingredients. It should be a minor player. In unethical and poor quality manufacturing it may make up 50% or more of the weight of the product. It should appear near the end of the additional or inactive ingredients list. Here's some more information on this.
Allergens: are often present in supplements. Due to the relative freedom that supplement companies enjoy, the presence of things like corn, soy, and wheat may not be clearly stated on products containing them. If you have an issue with any of these, or other items I would recommend that you seek products that clearly state they do not contain these ingredients. You can also call the company and have them send you confirmation that these ingredients are safely absent (in writing or email), not just verbal confirmation. Some things to look for include:
Zein: a corn derived protein coating.
Gluten: even if it doesn’t say on the ingredients assume it’s there, unless it states that it is free of it.
Maltodextrin: a corn derived starch
Whey, Casein, and Lactose: dairy derived ingredients
Soy Lecithin: soy lecithin is typically extracted from soybean oil, rather than from the bean itself and is rarely allergenic, however it still can be in people who are especially sensitive.
Dosage and Use
Supplements and herbs are capable of interacting with medications and their use should ideally be evaluated by an herbalist, naturopath or your acupuncturist. If you are on any of the following medications you are especially at risk for interactions.
Serotonin modifying medications such as Zoloft, Prozac, Celexa, Lexapro, etc.
Highy protein bound drugs: Warfarin, Phenytoin, Carbamazepine, Valproic Acid, Valium.
Digoxin
Some supplements, such as PGX and Huang Lian Su may be used specifically to decrease absorption, and will interact with your absorption of many medications. Magnesium can interfere considerably with the amount of thyroid medication absorbed. There are a number of contraindicated herbal combinations in traditional chinese medicine because the actions cancel one another out. Such combinations include seaweed and licorice and ginseng and radish. This is another reason that it is best to consult with a trained herbalist or naturopath when selecting supplements.
In general it is best to avoid supplements with long lists of ingredients. In that case there is often too little of each ingredient to have a significant benefit for your condition. If you have any adverse effects, you won’t know which ingredient you need to eliminate.
If a little bit of a supplement is good, more is not necessarily better. There is often an ideal therapeutic dose, below which you won’t get results and above which you either won’t get results, or you’ll get adverse reactions. Vitamin C is a good example of this. Above a certain dosage the Vitamin C is no longer absorbed and will result in diarrhea instead. Another concern is that when you take in a supplement your body requires particular metabolic pathways in order to convert that supplement to a usable form for you, or as it works in your body you need to metabolize the byproducts of it’s actions. Above a certain dosage your body can’t keep up with the byproducts. Toxins buildup and instead of helping you, your supplement is slowly poisoning you. Stick to your dosage recommendations.
Make sure you supplements have been independently analyzed by a third party. Any supplement company worth spending your money on will have their products independently analyzed by a third party. Because the FDA doesn’t do this, many companies realized the need to prove to their customers that their brands actually contain what they say they do. In order to do that they pay another company to come in and do quality analysis on their supplements. They ensure purity, potency, shelf stability, the lack of any contaminants, and the proper dissolubility of the products. Usually this will appear on the supplement. There are a few logos you can look for on your products to ensure that they are independently analyzed:
USP stands for United States Pharmacopeia. It is a non-profit group that analyzes products and those that pass are able carry their logo on the product:
There are quite a few other companies as well, and just because a product you are looking at doesn’t carry the USP logo doesn’t mean it isn’t quality assured. You often need to call the company and request a copy of their certificate for the product you are getting.
Maximize your benefit:
Water soluble vitamins get cleared out of the body faster, to maintain idea levels these need to be dosed multiple times per day. Examples include Vitamin C, B vitamins, and Choline.
Fat soluble supplements should bring more caution when it comes to pollutants and contaminants. Make sure that these especially are coming from reputable sources. Examples include: fish oil, flaxseed, CoQ10, Vitamin D, A, E, and K.
Minerals such as magnesium, iron, calcium and zinc are best absorbed with a small amount of an acidic material such as orange or tomato juice (this is especially true in the elderly who often have insufficient stomach acid production).
Phytates are naturally occurring molecules that plants use to store phosphorus. When these are consumed they bind to minerals in our diets, especially iron and zinc, but also magnesium and calcium and pull them out of solution (chelate) so that we cannot absorb them. Beans, tofu, grains, and nuts are some the largest sources of phytates in our diets. Taking mineral supplements with meals containing these molecules will significantly decrease the absorption of these minerals. (Also remember that a lot of grains and flours are enriched with these types of minerals, however they do us little practical good nutritionally because we can’t absorb them bound to phytates.)
Synthetic vs Natural: Vitamins are complex molecules and as such they possess the quality of "chirality". This means that they can exist in two mirror images configurations. When you look into the mirror you see yourself not identical to how people see you, but reversed, the same is true of chiral molecules. They can exist in what’s called a D or an L configuration. Identifying which is which involves shining light through a tube of the molecule and seeing which way it rotates the light. (I know, pretty far out huh?). When these molecules are being used by our bodies they are being plugged into enzymes and receptors. That means it matters which configuration they are in. In order to visualize this think about your two hands. They are chiral, in that they are mirror images of one another, that cannot be superimposed on one another. They look identical otherwise, but when you go to shake someone’s hand, if you have your right hand full and you go to shake their hand with your left hand, it doesn’t really match up and you have an awkward handshake, the right hands, or left hands however fit together nicely. Such is the case with the enzymes and receptors in your body. They are used to seeing molecules come in with a particular configuration, all of life has pretty much agreed that all amino acids are used in their L configuration and all sugars are used in their D configuration. When biological process create these molecules they are in their correct orientation. When the ingredients in your supplement come from natural sources they work well with the body. When they are synthesized in a laboratory they are made in equal parts D and L (in fact a good way to spot a synthetic supplement is to look at the ingredients and look for ingredients preceded by DL, such as DL alpha tocopherol). The part we can’t use needs to be excreted from the body, requiring biological energy that could be better used on making sure you are healthy and thriving.
Here’s your take away: make sure your supplements are:
-All independently quality assured.
-Sourced from natural means rather than synthetic.
-Not interacting with your medications.
-Not chalk full of additives, binders, flavorings, and colorings.
-Taken in a way to maximize the benefits and minimize the harms.
My list of recommended supplements. Unless you are totally dialed in when it comes to diet, I think these are things you should be on to maintain optimal health. These are links to these supplements available from manufactures I trust and use for my own patients.
Thanks for reading!
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