- while the Food and Drug Administration (FDA) regulates the dietary supplement industry, supplements are not held to the same regulatory standards as food or drugs? Essentially, dietary supplement manufacturers do not have to guarantee their dietary supplement safe and effective before placing it in the marketplace. In contrast, pharmaceuticals undergo several phases of study from animals to humans before they can be approved for use in the general population. In addition, the FDA provides oversight for supplements only after they are on the store shelves, if safety is called into question. More recently, some additional regulations were set in place to improve safety by establishing improved manufacturing practices and to ensure that the product contains what it claims to contain and nothing that could be harmful (i.e., lead). Unfortunately, even recent reports evaluating the content of certain supplements revealed that many of them either do not contain the ingredient(s) or contain less than what's claimed on the label. Even though the new guidelines were set in place to enhance supplement safety, I question how tight the monitoring will be. Plus, there is still no guarantee that the supplements are safe and effective.
- dietary supplements are also not standardized as prescription drugs are? What does this mean? Well, standardization involves following practices that ensure batch-to-batch consistency of a product or a high quality product. So, the contents of the supplement you bought six months ago will be consistent with the contents of the same product on the shelf today.
- just because a supplement contains naturally occurring ingredients does not mean it's safe? Natural does not = safe. Mushrooms are natural, but some contain natural toxins that are harmful. Arsenic, lead, mercury...these are all naturally occurring elements, but it doesn't mean that they're necessarily safe either.
- more isn't necessarily better? For one, when some nutrients, such as water-soluble vitamins like vitamin C or B vitamins, are consumed in excess of the body's needs, most excesses are excreted in the urine rather than stored in the body. Plus, higher levels may contribute to harmful toxicity disorders.
- depending on the ingredients and dosage, they may have negative interactions with other nutrients, foods, medications, or processes in the body? Symptoms of toxicity for nutrients most often occur from consumption of dietary supplements rather than foods. For example, high doses of iron can result in reduced absorption of copper and zinc and vice versa. Some dietary supplements can result in increased or decreased absorption or increased or decreased function of medications and vice versa.
- so far the only diseases or conditions that supplements, such as vitamins or minerals, cure are the ones caused by a deficiency of that nutrient? For instance, vitamin C does not cure the common cold, but it can cure scurvy, the vitamin C deficiency disorder. Even though we often see media clips about how a new research study shows that nutrients, such as vitamins of minerals, can help prevent or treat some condition, it doesn't necessarily mean that a supplement will do the same. In fact, several recent studies have shown that consumption of nutrients in supplement form may actually do more harm than good. For example, a study conducted some years ago found that beta-carotene (a form of vitamin A and weak antioxidant) in supplement form can actually increase lung cancer risk in smokers! More recent studies show that the antioxidant supplements of vitamin A, E, and beta carotene may actually slightly increase the risk of death.
- just because the person in the ad or a family member or friend says s/he took a supplement that helped with X, Y, or Z doesn't mean that it is actually a safe and effective treatment? Testimonials or anecdotal evidence are a great way to sell products, but they prove nothing.
- just because the product label or ad says the supplement does X, Y, and Z does not mean that the product is safe and works? Of course the company is going to tell you their product works, but don't you think they might have a biased opinion?
So, what do you do? Here are my quick tips:
- Consider buying recognized brands from well-established companies. These companies generally have more at stake because they want to be around for a long time, so they work harder to ensure a higher quality product.
- Scan the shelves for standardized products. How will you know? Look for the USP symbol. USP stands for the United States Pharmacopeia. This agency provides standards for the quality, purity, strength, and consistency of dietary supplements and conducts tests verifying the product ingredients, integrity, purity, and potency. Some other organizations or programs that provide similar standards or testing include: the Dietary Supplement Verification Program (DSVP),
- Read the Supplement Facts Panel. It's best to stick with supplements that provide no more than 100% of the Daily Value (DV), especially those that are considered more potentially harmful such as vitamin A, D, or iron.
- If the claims sound too good to be true, then they probably are. I always tell students and clients that if I knew of a product out there that really was the MIRACLE pill for weight loss or enhanced performance, etc. I certainly wouldn't want to keep that a secret.
- Run the dietary supplements by your healthcare provider before using them. In fact, I always ask my clients to bring their supplement containers with them to our visits so that I can help them evaluate these products.
- Remain skeptical of the latest headlines. They make good stories, but the sound nutrition or health advice is typically based on a broad body of research and not a single study. Who were they studying? How many people were in the study? How long was the study? There are many factors to consider, and one study alone does not mean the results are generalizable to the population at large or to you specifically.
- Finally, lots of research powerfully indicates that foods, not supplements, are the best source of nutrients.