What I wish everyone knew about Supplements.
Before I jump in, I want to point out that I am a believer in "educated supplementation" not "hey, this looks good...I so need this!" Although I promote Food First, most people's lives are indoor-based, heavy on processed food and snacks and full-o-stress. Add to this that the soil we grow our food in is very depleted and conventional meat can be highly toxic, inflammatory and lacking the vitamins and minerals we need just to meet the RDA level. Side note: the RDA level is based on the nutrient requirements of 97-98% of healthy people.
Whole Food First. Then Plug the Gaps.
Any nutritionist worth their salt will recommend to first eat high quality, organic, non-processed foods to help reach those recommended nutrient levels. But there are times when supplementation is necessary. Most people should be taking a high-quality multi- vitamin geared for their age group (your vitamin and mineral levels change depending on your age). And sometimes you need some help. For example, Vit. D (if you live in the Pac NW for example), DHA/EPA (for so many reasons) or B12 (vegans, the elderly, those with malabsorption issues). So we are lucky we have that opportunity to plug in nutritional gaps to feel our best.
The Cautionary Tale
The DOD created a free website called The Human Performance Resource Center because so many of our warriors were getting seriously hurt or dying from taking mega-doses of supplements. Particularly ergogenic aids (fitness).
In 2014, the FDA reported that the number of "Adverse Event Reports" due to dietary supplements went from 687 (in 2008) to 3289 (in 2013). Just so you understand, an "Adverse Event Report" means life-threatening or death, not just a tummy ache.
And it's not just those fitness-based supplements you need to worry about. Just taking high doses of something like Vitamin A is dangerous. An adult male needs 900 mcg a day of preformed Vitamin A. The tolerable upper limit (UL) is set at 3000 mcg/day for healthy adult males. This is the limit that poses no health threat to most of the population. Toxicity is reached when someone takes 8000-10,000 mcg/day for a longer period of time. This may impossible to reach, but if you take a multivitamin supplement every day (some have 1500 mcg in them), a separate supplement for skin or immunity health that has Vit. A in it you're getting up there. Now add in the real healthy food you're eating: a couple tablespoons of cod liver oil (a tsp has 1350 mcg) and few eggs (80 mcg each) and you're getting close. Signs of chronic toxicity (that 8,000-10,000 range) include dry itchy skin, desquamation, anorexia, weight loss, headache, cerebral edema, enlarged liver, enlarged spleen, anemia, and bone and joint pain. So keep the whole food sources but monitor the supplemental sources.
(*FYI-There are two dietary forms of Vit. A: Preformed (animal sources) and ProVitamin A (fruits/veggies). Preformed have a much higher bioavailability rate.)
"But I'm careful not to mega-dose!"... "I only buy from GNC/Vitamin Shoppe/Amazon/Ect"
Here's the bread and butter of this article that I hope makes you think.
Thousands of supplement companies open all the time. They make enticing claims (it's called marketing) and some seem...a little absurd. Buying from a big box store can be convenient and economical. And sometimes it's all you have. I get it. But it comes with risks.
The first issue is quality control. It is up to the FDA to prove that a supplement is unsafe or adultered. That's right. And since there are literally thousands of supplement companies, with many more opening every day, do you think the FDA has the manpower to check the quality or claims of each bottle (or company for that matter)? They don't. A dishonest man can open a supplement company, make a bunch of crazy claims with very poor quality ingredients (if they even use the ingredients they say they are) and split with their millions before the FDA has a chance to check their product.
How does quality control work?
There is something called GMP or Good Manufacturing Practices that all companies are supposed to comply with. It regulates the physical plant, the product, maintenance and cleaning and quality control along with a few other things. Of the 341 companies audited in 2012, only 27% of them were in compliance (and think, that's only 341 companies in the USA). The major compliance issues were:
- product identity: sometimes what you think is in the product isn't...and you may be getting something you didn't even want.
- quantity of ingredients: your product may have more or less of what it states (remember the Vit. A story?)
- ingredient safety: there may be things you really don't want like lead, arsenic or mercury.
- adulteration: there may be banned ingredients in your supplement (i.e. ephedra)
And if you think the FDA or FTC can monitor supplements made or sourced in other countries, you're really in for a big shock. Although they can regulate, they can't monitor every batch that comes into our country.
The second issue is that many supplements (vitamins, minerals, etc) can interact in dangerous ways with prescribed medication. Take Saint John's Wort for example. Commonly used for depression. But if a female takes Saint Johns Wort and oral contraceptives, she's putting herself at risk for getting pregnant. Why? Because Saint Johns Wort increases the metabolism of oral contraceptives, leaving a woman open to an unwanted pregnancy. (Yikkees!)
So what do I do now?
To find quality, safe products buy from reputable companies that test EVERY batch, have 3rd party certifications and are bought from a reputable source (say your local nutritionist vs online). For a list of GMP certified companies, click here.
Some 3rd party seals to look for are:
To see who got warning letters from the FDA (remember, your supplement company may not have even been checked yet):
And finally, just a few very reputable brands to look for:
Professional lines (available through healthcare providers)
Integrative Therapeutics Inc.
Pro Thera / KlaireLabs
Designs for Health
Retail Lines (available at health food stores)
Nordic Naturals (fatty acids)
Garden of Life