What is in your supplement?

The estimated size of the US dietary supplement industry is $25 billion for 2010. That number is not particularly surprising when weekly advertisements tout a new supplement to cure everything from high cholesterol to diabetes.

So what happens when you do give in to these advertisements? Or, you decide to buy nutritional supplements based on another friend’s recommendation? What do you choose? Remember, you pay for what you get!

A few things to think about:

1) Quality assurance
Sadly, not all vitamins are created equal. In fact, often times, there can be huge discrepancies in nutraceutical products with some being contaminated with heavy metals, solvents or chemicals.
Quality assurance is measured by authenticity – the ingredients on the label match the ingredients in the product; potency – the amount of each ingredient on the label is the minimum amount contained by the expiration date; and purity – the ingredients are free of fillers, additives, and contaminants.
The FDA recently established dietary supplement good manufacturing practices (GMPs), guidelines of general principles for manufacturers to keep products safe, effective, and free of contaminants. Third-party audits are carried out by organizations such as Natural Products Association (NPA), United States Pharmacopeia (USP) and/or National Sanitation Foundation (NSF).
In order to identify a higher quality supplement, look for companies that are GMP certified, or have their own in-house testing by conducting laboratory assays. It pays to know about the companies you are buying from.

2) Can your body digest and assimilate the supplement?
It is possible to find vitamins and minerals in many different forms, with some being more bioavailable and better for digestion and absorption compared to others. A good example of this is vitamin E. The natural form of vitamin E your body can use is d-alpha tocopherol, though some companies opt for the cheap, synthetic version called dl-alpha tocopherol. It is always a good idea to take a look at the label and especially the fine print in order to fully understand what you are buying.
While you are looking at that label, you don’t want to see excessive non-organic mineral salts, such as chlorides, oxides, phosphates, and sulfates which are inexpensive and relatively non-absorbent. Instead, look for organic salt acids such as citrates, chelates, picolinates, and gluconates, which are the more absorbable forms to increase bioavailability.
A good way to test bioavailability at home is to see how quickly a tablet is able to disintegrate in solution. Supplements that dissolve quickly can be more available for absorption in your intestinal tract. Higher quality supplements will dissolve within 30 minutes.

3) Extra things you didn’t know you were getting
Apart from the active ingredients listed on the label, companies use excipients – non-medicinal substances that are inactive but serve a role as fillers, binders, preservatives, lubricants, coating agents, or emulsifying agents.
The less number of excipients used, the better your product. Look for any number between 4-8 to ensure the required function of the supplement without sacrificing quality. Acceptable excipients are from only natural sources include: from plants – starches, sugars, cellulose; animal – lactose, gelatin, stearic acid; or minerals – calcium phosphate, silica.
Definitely avoid any supplement that contains artificial food colorings, which can cause allergies or have been shown to be carcinogenic. Look for D&C or FD&C on the label.

4) Dosing – too much, not enough, or not at all?
It is very common for patients to come in with a list of supplements that they are taking because they heard that it is good for them. What often happens is the dosage of each supplement is not enough or maybe not even appropriate at all.
Relying on a label’s RDA (Recommended Daily Allowance) value doesn’t guarantee optimal dosages, rather just the minimal amount to prevent disease. Therapeutic dosages are often many times higher than the RDA.

It is very important to disclose all dietary supplements to your doctor to get better guidance on dosage instructions. Naturopathic doctors are trained in nutritional and herbal supplementation as well as potential herb-drug interactions. If you have a preexisting condition, it would better to discuss supplement needs with your doctor, who can then guide you on dosage, timing, and your body’s nutritional needs.

Dr. Rhodo Nguyen is a Naturopathic doctor who sees patients in our spa M-F, call 202.328.9642 to book an appointment.

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