Choosing Nutritional Supplements Wisely

Recently, Consumer Labs, an independent testing agency, did a random test of 32 over-the-counter (OTC) supplements. Of these 32, only ten met the claims on their labels for what they contained and the amounts that they claimed were in their supplements. In its study, Consumer Labs also found: one female multi-vitamin contaminated with 15.3 micrograms of lead per serving; a children’s multi-vitamin that contained 216% of the amount of Vitamin A it claimed to have; 3 multi-vitamins that did not break down in the body; and one multi-vitamin that contained none of the Vitamin A it claimed to have. With results like these, it is no wonder consumers are lost on how to choose their supplements.

History of Supplement Regulatio

First, let’s start with the definition of a “dietary supplement.” In 1994, Congress passed the Dietary Supplement Health and Education Act (DSHEA), which defined supplements as “any product taken by mouth that contains a dietary ingredient intended to supplement the diet, which may include vitamins, minerals, herbs or other botanicals, amino acids…enzymes, organ tissues, glandulars, and metabolites.” All supplement manufacturers are under the loose oversight of the Food and Drug Administration (FDA.) It is “loose” oversight, because each company is individually responsible for determining that what it manufactures or distributes is safe and that any claims their labels make are substantiated by adequate evidence. The FDA only requires governmental approval for “new” ingredients that haven’t been on the market yet. After the DSHEA was passed in 1994, the FDA was supposed to publish a “Good Manufacturing Practices” document, which would have made it easier for the agency to inspect manufacturing plants and individual batches of supplements. Thirteen years later, though, this document still hasn’t been published.

USP Grade Supplements
The next best regulatory agency in lieu of the FDA is the United States Pharmacopoeia. This is a self-policing group that supplement manufacturers voluntarily join. It is meant to bridge the gap until the FDA publishes the GMP. The group is non-governmental, and non-public, which is meant to build consumer confidence in the companies that adhere to their manufacturing standards. To be a USP manufacturer, supplements must contain the ingredients declared on their label, must contain the amount or strength of each ingredient listed on the label, must meet requirements for limits on potential contaminants, and must adhere to good manufacturing practices. Companies in the USP have “USP” clearly written on the label. These supplements can be found over-the-counter.

Physician Grade Supplements
The best option for consumers is to purchase “Physician Grade” supplements. These are supplements available only to and marketed exclusively to health care providers. They hold themselves to higher standards, and therefore have better results. This is important, because when companies provide products to a health care provider, they know the results will be monitored. If the supplement doesn’t do what it should, the provider will stop recommending it to his patients. These companies also have better educational tools for the doctor, including trained and qualified employees to answer any questions. They have Ph.D. scientists and pharmacologists researching and developing their products. These companies also do individual assays on every lot, instead of just spot checks to make sure their products meet label-claims. Health care providers often insist on seeing the test results before deciding to recommend the product to their patients. Their products are formulated with a specific result in mind, and are designed to be part of a health care protocol. Over-the-counter supplements, on the other hand, are designed for maximum sales and profit.

Summary
Consumers need to understand that when purchasing supplements, what they think they are buying may not be what they are getting. You may pay slightly more for supplements from your health care provider, but you will know you are getting the top of the line, and when it comes to your health, that is what is most important.

References:

Stechschulte, Pattie. “Standards for Nutritional Supplements.” Today’s Chiropractic, Jan/Feb 2003.

Wood, John V. “Physician Grade vs. OTC: Why Your Recommendations Make the Grade.” Chiropractic Economics, March 13, 2007.