Patients often ask questions about nutritional supplements. Do they work? Should they take them? The answer, of course, is "it depends"—and it depends on a wide variety of factors at that. Even if you get the greenlight from your doctor to try a supplement, this leads to an important follow-up question: how to choose the right nutritional supplements?
We asked the folks at Theralogix, a nutritional supplements company based out of Maryland, to provide some guidance. (Note: some GBU physicians recommend Theralogix products to patients; the following article isn't an endorsement, nor is it intended to be medical advice; always talk to your physician before adding a supplement to your regimen.)
Today's guest post was written by Tiffany Graham, MPH, RD, LD. Mrs. Graham is the VP for Research and Education at Theralogix.
Dietary supplements are sold everywhere. You can buy them at grocery stores, gyms, or even some gas stations. With so many choices, how do you know what to buy? And how do you know what you are buying is even safe?
A 2018 consumer survey conducted by the Council for Responsible Nutrition (CRN) found that 75% of adults in the U.S. take nutritional supplements, up 10% over the last decade. When survey participants were asked why they take a supplement, the top response was “to promote overall health and wellness.”
There are many good reasons to take a nutritional supplement. Many people take supplements to help fill nutrient gaps, which are common in a standard American diet. For some, supplements may decrease or postpone the need to take prescription medications, or even reduce the risk of complications and side effects from certain medical treatments.
There is no question that nutritional supplements can play a role in your overall health and wellness. However, it is very important to choose your supplements wisely.
Since 1994, when Congress passed the Dietary Supplement Health and Education Act (DSHEA), the Food and Drug Administration (FDA) has loosely regulated dietary supplements. DSHEA does not require dietary supplement manufacturers to prove that their supplements contain what is on the label, are effective, or even safe. The FDA regulates dietary supplements as food, which means they are not subject to the same safety and effectiveness testing required for prescription drugs.
Since 2010, supplement manufacturers are required to follow what is called Good Manufacturing Practices (GMPs). The GMPs were established to ensure supplements are safe to consume. While all companies are now required to follow GMPs, many still do not. In some ways, purchasing a dietary supplement remains a “buyer beware” scenario.
Here are the top 3 things to keep in mind when choosing a nutritional supplement.
1. Choose supplements that are independently tested and certified.
This is the number one way to make sure that your supplement contains what it’s label says it does. Third-party testing and certification agencies such as NSF® International and USP® work with companies to verify the content accuracy and purity of dietary supplements. In other words, the USP or NSF certification seal assures you that the product contains exactly what is shown on the supplement facts panel, and nothing more. It also ensures that the product contains no undeclared ingredients or unacceptable level of contaminants.
These programs also test for product disintegration. This means that the tablet, capsule, or softgel breaks down properly to allow its ingredients to be available for absorption in the body.
Additionally, NSF audits manufacturing facilities twice a year to ensure that GMPs are being followed. NSF certification also guarantees that only the highest-quality ingredients from NSF-approved suppliers go into your supplements.
Choosing a nutritional supplement with the NSF mark or USP seal is your quality assurance of its content accuracy, purity, and freedom from contaminants.
2. Choose products with evidence-based formulations.
Be sure to do your research on vitamins, minerals, and botanical (plant-derived) ingredients before purchasing a nutritional supplement. The form and amount of each nutrient is important. Some forms of nutrients are better absorbed than others. Research studies that have shown benefit for various conditions have used specific forms and doses of a nutrient. These forms and doses are not necessarily represented in every supplement. Also remember, more is not always better. You want to make sure that the amount of each nutrient is safe and does not exceed the tolerable upper intake level (UL).
For herbal or plant extracts, it is important to know what type of extract has been used in research studies, how the extract is standardized, and what dose is needed for benefit. For example, if you are choosing a cranberry supplement for urinary tract health, be sure to choose a whole cranberry extract standardized to contain 36 milligrams (mg) of proanthocyanidins (PACs) per daily dose. This is the amount that has been shown to have benefit. Most cranberry products are not standardized for PAC content, and do not list the amount of PACs on the supplement facts label. This makes it quite difficult to compare various cranberry products.
TheraCran One, made by Theralogix, has been independently tested and certified by NSF International. Read how Dr. Angel Marie Johnson, the director of the Women's Health Center at Greater Boston Urology in Dedham, uses TheraCran One in her practice.
3. Avoid proprietary blends. Choose transparency.
Proprietary blends are often in supplements that contain various herbal or botanical extracts. Consumer Reports explains that a proprietary blend is a special blend of several dietary supplement ingredients. The main problem with this type of “secret recipe” blend is that although the ingredients must be listed in order from highest to lowest content, the amount of each ingredient in the blend is not revealed.
Knowing the amount of each ingredient in your supplement is important for many reasons. You want to make sure that the dosage of each nutrient is safe, research-based, and appropriate for you. Many dietary supplement companies are shying away from using proprietary blends to increase consumer trust. Customers have the right to know exactly what is in their supplements. For these reasons, stay away from products that contain proprietary blends. Instead, choose dietary supplements with transparent labeling.
Transparency not only applies to clear labels listing the form and amount of each active ingredient, but also the company’s ability and willingness to have conversations with customers about their products. Look for companies that employ Registered Dietitians and other healthcare practitioners who are available to answer your questions.
As a savvy shopper, you want to do everything you can to make sure you are buying safe, effective dietary supplements. Choose supplements that have been independently tested and certified for content accuracy and purity. Only purchase products that are backed by good science and contain the amount of each nutrient that is best for you. Finally, choose a supplement brand that believes in transparency in labeling and open customer communication.
Thanks for stopping by the blog, Mrs. Graham!
Remember, if you have questions about supplements, talk to your doctor. If you’re in the greater Boston area and need a urologist, schedule an appointment with one of our board-certified physicians.