The recent New York Times and Post columns accusing GNC, Walmart, Walgreens and Target of carrying fraudulent supplements inspired a write-up on the topic of supplement quality. New York Attorney General, Eric Schneiderman, sent a letter to the companies demanding removal of adulterated supplements. The attorney general conducted five genetic tests per each of four samples purchased at different store locations.1 These tests revealed that four out of five herbal supplements contained none of what was claimed. Instead they were filled with rice, asparagus, house plant material, garlic and wheat despite gluten-free claims.2
Although supplements are regulated by the FDA in America, dietary supplements fall under a different set of regulations than food called the Dietary Supplement Health and Education Act of 1994 (DSHEA).3 Although the DSHEA prohibits the sale of falsely labeled products, it is up to the supplement company to evaluate and label their products appropriately. The DSHEA is essentially an honor code that relies on the moral of each profit driven company to provide labeling information.
Patient’s commonly tell me that they have already tried a supplement and it has not worked. This leads me to review proper identification of a beneficial or detrimental supplement. As a Naturopath, not only do I find great value in supplements but I see clinical changes in my patients with the appropriate use of professional vitamin and botanical support. Fish oil is a prime example. There is a plethora of research supporting the use of fish oil for a reduction in inflammation, reduced cholesterol, and improvement in pain conditions. I believe in the use of Fish oil to maximize health. And don’t get me wrong, I love a bargain, but when you purchase 300 capsules of fish oil in a clear plastic bottle, it is likely not a healthy supplement. Oil oxidizes and becomes rancid in unstable conditions and low quality plastic leaches into different supplements.4 My common refrain is “you’re throwing your money in the garbage” which is reflected in Nutritionist David Schardt of the Center for Science in the Public Interest’s comment that “consumers should stop wasting their money”.5
My argument is that there are high quality, beneficial supplements out there. And it is important that the consumer know how to buy a supplement with confidence. So I’m including some key factors to look at when purchasing a supplement.
Supplements versus Medications
First, always check any interactions between supplements and the medications that you are already taking. For example, St John’s Wort is a well known supplement that commonly interferes with the metabolism of many important medications.
Ingredients
Second, look at the ingredients. Look beyond the active ingredients to the inactive ingredients. If you see sweeteners, artificial flavor and dyes, it is likely that it is a sub-par product. Many supplements may not carry the listed ingredient and they may use petroleum and other chemicals as binders in their tablet formation. Parentheses should be following each vitamin listed. For example Vitamin B12 should look something like this Vitamin B12 (as methylcobalamin) or if you are looking at a food based supplement Vitamin B12 (from nutritional yeast).6 The first supplement is identifying the B12 as chemically compounded and the second is grown from a bacteria. Both have value and their source is identified. If the label does not tell you what form the vitamin is in, then you don’t know anything about the source or quality. If you see that the parenthesis are listed, you know the supplement company is taking it one step beyond the requirements of the DSHEA.
Allergies
Third, see if common allergens are listed. Companies that care will mark that their product is free of common allergens that will not only make some people ill but also interfere with the healing process. But, as we learned above, don’t always trust the label because some companies will write down whatever they like.
Seals of approval
Fourth and most important, look for quality seals of approval beyond the usual good manufacturing practices (GMP). Some of the additional abbreviations you can look for include USP, TGA, NSF, EQP. USP stands for the US Pharmacopeial Convention. The USP label assures the consumer that the product meets a voluntary supplement verification process.7
TGA stands for Therapeutic Goods Administration. TGA is an Australian certification ensuring that the quality of vitamins is fit for human consumption and properly labeled.8 NSF or the National Sanitation Foundation established the National standard for dietary supplements. The National Standard for dietary supplements has participation from the US Food and Drug administration, the National Health Institute as well as other Federal and State regulatory agencies. NSF tests products for toxicology and formulation to ensure purity.9 EQP is a smaller, national label from Emerson Ecologics. Emerson Ecologics is an online provider of high quality, professional supplement formulations. Emerson offers their EQP silver and gold labels to companies that they have evaluated for proper manufacturing practices as well as appropriated product design, manufacturing controls and raw ingredient and finished product testing.10
Expiration Date
The fifth and final piece of advice is look at the expiration date. Products that have no expiration date or are expired should not be consumed.
Here you have five steps to know the quality of the supplements and vitamins you purchase. Don’t write every supplement off, but take the time to make sure that your money spent is worthwhile with these simple steps or ask a qualified healthcare professional for help.
Dr Knapp believes in the symbiosis of humanity and the environment. It was during her work as a small farmer after college that Dr Knapp recognized her goal to heal the earth by helping its inhabitants heal themselves.
Dr Knapp received her Doctorate from the National College of Natural Medicine with a specialty in Natural Childbirth. She currently practices as “a doctor who listens” in Vancouver, WA. Dr Knapp is a member of the AANP, WANP and a writer for the NABNE. Dr Knapp enjoys spending time with her family, preparing meals with locally procured foods and grounding herself by getting her feet wet in any nearby body of water.
About me: I am a fan of all things DIY…leading to many less than perfect projects in the home. I love to play indoors or out with my family, preparing meals with locally procured foods and grounding myself by getting my feet wet in any nearby body of water.
Resources:
1. Schneiderman, E. Retailers Are Warned Over Herbal Supplements. The New York Times. 2015. Available at: http://www.nytimes.com/interactive/2015/02/02/health/herbal_supplement_letters.html. Accessed February 15, 2015.
2. O’Connor, A. New York Attorney General Targets Supplements at Major Retailers. Well New York Attorney General Targets Supplements at Major Retailers Comments. 2015. Available at: http://well.blogs.nytimes.com/2015/02/03/new-york-attorney-general-targets-supplements-at-major-retailers/?_r=0. Accessed February 13, 2015.
3. Unknown. US Food and Drug Administration. Dietary Supplements. 2014. Available at: http://www.fda.gov/food/dietarysupplements/. Accessed February 12, 2015.
4. EFSA, . Scientific Opinion on Fish Oil for Human Consumption Food Hygiene, including Rancidity1. European Food Safety Authority. 2010;8(10). Available at: http://www.efsa.europa.eu/it/search/doc/1874.pdf. Accessed February 13, 2015.
5. Press, A. Most herbal supplements aren’t what you think they are. New York Post. 2015. Available at: http://nypost.com/2015/02/04/most-herbal-supplements-arent-what-you-think-they-are/. Accessed February 15, 2015.
6. CFR – Code of Federal Regulations Title 21. CFR – Code of Federal Regulations Title 21. 2006. Available at: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=101.36. Accessed February 15, 2015.
7. USP. U.S. Pharmacopeial Convention. USP Verified Mark. 2014. Available at: http://www.usp.org/usp-verification-services/usp-verified-dietary-supplements/usp-verified-mark. Accessed February 15, 2015.
8. TGA. What the TGA regulates. https://wwwtgagovau/what-tga-regulates. 2015. Available at: https://www.tga.gov.au/what-tga-regulates. Accessed February 15, 2015.
9. NSF. Dietary Supplement Certification: Quality and Safety Provider. NSF The Public Health and Safety Organization. 2014. Available at: http://www.nsf.org/services/by-industry/dietary-supplements/dietary-supplement-certification. Accessed February 13, 2015.
10. Chasse, J. Emerson Quality Program (EQP) Summaries. Emerson Quality Program (EQP) Summaries. 2014. Available at: https://www.emersonecologics.com/quality/qualitysummaries.aspx. Accessed February 15, 2015.
