Vitamins and Dietary Supplements: The Low-Down
Supplements are everywhere. I know 5 people selling them from “reputable brands” right off the top of my head. They are super popular and who can blame anyone for looking for a quick remedy for what ails them? Seems like a no-brainer.
But WAIT – before you run out and order a million little colored capsules, READ this. It’s important.
- ALWAYS talk to your doctor and/or other health professional (pharmacist or RD) before starting any supplement. If you heard xyz- supplement is amazing from your cousins’ best friends plumber’s wife, first find out if that is right for YOU. Not everyone has the same experiences and reactions, and you may have a medication interaction or health consequence that only your doctor could identify. For instance taking a calcium supplement may increase your risk of kidney stones especially if you are prone to them or have family history (while calcium from food decreases kidney stone risk). Your doctor will know your specific needs based on bloodwork and other health factors, and your pharmacist and dietitian can help with drug and food interactions.
- Supplements are just that: supplements. They are not substitutes for a healthy diet. They should not be taken in place of prescription medications. They are literally only regulated for safety and manufacturing practices so should not be used as medical care or to treat or cure a disease or ailment. Talk to your dietitian and physician about healthy food choices and regular exercise, as many conditions have a medical nutrition therapy that RD’s are trained to help you utilize. In the spirit of full honesty, supplements do not play a very significant role in overall health, so no need to waste your money unless a supplement is deemed medically necessary.
- Consider the dosage – more is not always better. In my clinical rotation, I encountered a woman who was taking 14 different dietary supplements. After putting all of the supplements in a big spread sheet and tracking each active ingredient, I found she was taking up to 7,000% daily recommended value of some of the ingredients! Once I showed her the spread sheet, she realized she didn’t need over half of what she was taking. This is what I like to call “Expensive Urine”! Most vitamins and minerals are water-based and you will excrete what you don’t need. However some lipid-based vitamins, such as Vitamin A and D can build in your body at toxic levels and have serious consequences. Again, talk to your medical professional about what you need.
- After breaking down the 14 supplements, I asked my client why she was taking so many supplements. She really couldn’t tell me, other than she was told by the woman who ran the health food store what to take them for (she complained of muscle spasms, sleeplessness, etc). Apparently the previous owner of the store was a pharmacist who created one of the supplements, so she trusted him, and by default she trusted the daughter who was now running the store (who was not a pharmacist or other medical professional). The story of this woman I mention brings me to my next point: Where are you getting your supplements from and whose advice are you listening to? When I asked the woman if her doctor had prescribed any of the supplements, she said no, and that he probably wouldn’t want her taking them. At that point I reinforced how important it was to talk to her doctor about them. I also skirted around the idea that the owner of the store had likely taken advantage of her, because she had gained the trust from her father. As I said, the daughter was not in any way a medical professional, and she should not have been guiding or recommending supplements to anyone. But business is business and there are plenty of bad players out there. Businesses have a bottom line to attend to, and while not everyone selling supplements is bad, they are not professionals, nor do they know what YOU need based on your health status.
- Get a USP or NSF verified product. Once you’ve talked to your MD, RD and pharmacist about the supplement, you’ll want to be sure you get what you are paying for. The food arm of the FDA regulates supplement manufacturers for safety in manufacturing as well as labeling, but not for the actual ingredient verification. In fact, several large studies found both echinacea (thought to boost immunity) and melatonin (thought to aid in sleeplessness) supplements did not contain the amount of each ingredient as stated on the label! (This is actually a huge problem in the research of these two ingredients, but I’ll save that tangent for another day) So what can you do? There are two different third party companies out there that test supplements for actual ingredient content, as well as safety: USP and NSF. If you see the marks of these companies on supplement brands, (usually a little round symbol on the front of the label), then you can trust that the dose is accurately described.
6. Only prescription medications are researched and tested for specific health claims. Supplements are not. Drugs are highly regulated and rigorously tested for years before marketed to consumers for disease prevention or treatment. Supplements on the other hand are not put through this process. This is one reason why there are so many brands of supplements out there, and why the points in this article are so important to know. The FDA allows general claims on supplement labels, such as “Calcium builds strong bones” but they must also include a disclaimer that their product does not claim to “diagnose, treat, cure or prevent any disease” (Only drugs can do that). In this case, you must remember just because the supplement can include a health claim, the supplement is not directly correlated with that health outcome. In other words, the supplement in hand (calcium) does not claim to prevent osteoporosis.
To reiterate once again, your MD, RD and pharmacist can clarify all of these things and lead you in the right direction.
The take home message? Have a conversation with at least one medical professional before taking any supplement. Do not prescribe yourself anything. Do your homework and validate where the information is coming from, as well as who is creating and testing the supplement, and what it may or may not be used for.
There’s no one-size-fits-all, and there may be alternative ways to achieve your goals that are healthy, inexpensive, effective and sustainable!