By Jean Copeland, RD
***Note: The science behind dietary supplements is very limited. Before taking any supplement, even if it seems perfectly safe, consult your Primary Care provider to identify potential interactions and weigh risk versus benefit. We can’t emphasize enough that eating vitamins and minerals through a healthy diet is the best way to get these nutrients; often supplements are not well absorbed and may be a waste of money.
Have you ever walked into a drug store or the pharmacy section of a supermarket, looked at the rows of dietary supplements, and thought, “How do I know which one is best?”
Since our bodies can’t make vitamins and minerals, we must get these essential nutrients from our food and drink. In the United States, despite our plentiful and varied food supply, many people choose every day to eat foods that have few essential nutrients, such as vitamins A, C, and E, and magnesium, a mineral. Such a diet can lead to poor health over time. Additionally, many Americans take prescription medicines that may interact with specific nutrients, while others simply require more of certain nutrients because of their unique metabolism.
So, while food is the best source of nutrients for our health, there are many reasons why we may be missing some nutrients.
‘Fortified’ and ‘Enriched’
Over decades, our government has enacted programs to fortify or enrich many of the processed foods we eat. When a food is “fortified,” nutrients are added that aren’t naturally in the food. Some examples are adding iodine to table salt, calcium to orange juice, and vitamins A and D to skim milk. “Enriched” foods are processed foods that lost nutrients during processing, so these nutrients are added back to the foods to replace what was removed during processing. Examples are the B vitamins in enriched white bread and cornmeal.
As a result of fortifying and enriching foods, Americans rarely suffer from diseases caused by nutrient deficiencies. But many Americans do suffer from nutrient inadequacies, where they’re eating enough nutrients to prevent outright diseases like beriberi, pellagra, rickets, goiter, spina bifida (in offspring), etc., but not eating enough nutrients to be truly healthy. Nutrient inadequacies show up as general fatigue, inability to fight infections, impaired brain function and thinking, irritability, anger, and overall pain. Over years, nutrient inadequacies may increase one’s risk for chronic diseases like cancer, cardiovascular disease, Type 2 diabetes, osteoporosis, and age-related eye disease.
The Sale of Supplements
The supplement industry in the U.S., which includes the sale of vitamins, minerals, herbs, hormones, sports drinks, protein bars and powders, and nutrition beverages, is huge and growing. To consumers, supplements may look similar to prescription medicines—packaged in bottles and boxes and sold in reputable retail stores—giving the impression that supplements are as safe as our prescription drug supply. But while pharmaceutical companies must provide evidence to government inspectors of ingredient certifications, quality production records, temperature delivery records, etc. the dietary supplement industry has none of these laws. Buyers should be aware that companies A, B, and C can all offer to sell you melatonin, for example, but nobody is required to check the pills inside the bottles to see if they actually contain melatonin! Yes, you read that right. It is possible to buy melatonin tablets that contain no melatonin, and herbal supplements to soothe your nerves that contain dried lawn clippings.
The Food and Drug Administration (FDA) regulates product safety and identity as well as health claims on product labeling, but there are no laws governing product testing for contents or quality. We rely on manufacturers to voluntarily follow good manufacturing practices, or GMPs. The Federal Trade Commission (FTC) regulates the health claims made in product advertising while the Natural Products Association (NPA), a voluntary industry organization, leads in industry regulation and advocacy.
So how do you know which supplements are safe to buy? First, it is important to remember that the science behind dietary supplements is very limited. Before taking any supplement, please discuss with your Primary Care provider to identify potential interactions and weigh risk versus benefit. Here are a few additional resources:
ConsumerLab.com (CL) is a subscription-based service that helps consumers evaluate dietary supplements prior to buying. Similar to Consumer Reports in reviewing products with consumer needs in mind, CL is not a laboratory but contracts studies to outside laboratories. It purchases supplement products and other consumer goods directly from public storefronts and publishes reports based on the results. You can buy a membership to ConsumerLab.com for about $3 per month, which gives you access to information unavailable elsewhere concerning supplement test results, product prices, quality reviews, and comparisons of similar products.
Reputable dietary-supplement manufacturers test their products during manufacturing of every batch to ensure quality, but this is not required by law. Therefore, many companies do not test their products as frequently. As quality tests require personnel, specialized equipment, space, and time, you can expect to pay higher prices for supplement brands that ensure product quality with every batch.
Supplements are also divided into two markets: professional supplements, which are sold through health and wellness professionals who earn a portion from each sale, and retail supplements, which are sold at the local grocery or drugstore or online. As with anything, products being sold person-to-person are likely to be more expensive than what you can buy at the local store. But generally, person-to-person sales come with guarantees of quality and often a money-back guarantee if you are not satisfied (think Mary Kay or Avon skincare companies).
Bearing these things in mind, here are several dietary supplement retail brands that have proven to be of high quality and dependable. This is not an all-inclusive list; many more manufacturers could be added.
-Garden of Life
The following websites offer free Drug Nutrient Interaction Trackers to identify potential interactions, including depletion and magnification of effects:
More general, reliable resources about dietary supplements can be found here:
–Office of Dietary Supplements, National Institutes of Health
–National Center for Complementary and Integrative Health
–Linus Pauling Institute, Micronutrient Research Center
For information about Gifford resources to help you achieve your nutrition, health and lifestyle goals, visit giffordhealthcare.org/service/nutrition-counseling or call 802-728-7100.