The Dangers of Nutritional Supplements & 3 Things to Consider When Choosing Nutritional Supplements

Nutritional supplements are vitamins, minerals, herbs, or extracts of natural products that are used for preventative medicine (i.e.,multivitamins and fish oils), alternatives to pharmaceutical medication (i.e red yeast rice for high cholesterol), and medicine for optimal care (probiotics for digestive health). 

Nutritional supplements and vitamins are regulated in the US by FDA under the regulations of theDietary Supplement Health and Education Act (DHSEA) (http://www.fda.gov/opacom/laws/dshea.html) which was enacted in 2004 to regulate nutritional supplements under the same category as foods.

DHSEA of 1994 stated:

• There is a link between the ingestion of certain nutrients or dietary supplements and the prevention of chronic diseases such as cancer, heart disease, and osteoporosis
• Preventive health measures, including education, good nutrition, and appropriate use of safe nutritional supplements will limit the incidence of chronic diseases, and reduce long-term health care expenditures;
• National surveys have revealed that almost 50 percent of the 260,000,000 Americans regularly consume dietary supplements of vitamins, minerals, or herbs as a means of improving their nutrition
• Studies indicate that consumers are placing increased reliance on the use of nontraditional health care providers to avoid the excessive costs of traditional medical services and to obtain more holistic consideration of their needs
• The nutritional supplement industry is an integral part of the economy of the United States & the estimated 600 dietary supplement manufacturers in the United States produce approximately 4,000 products, with total annual sales of such products alone reaching at least $4,000,000,000
• Dietary supplements are safe within a broad range of intake, and safety problems with the supplements are relatively rare

In June 2007 DHSEA was amended to include quality controls for nutritional supplements after multiple incidents of claims on the supplement bottles that did not match the ingredients inside the bottle. 

From DHSEA of 2007:

*Use of nutritional supplements (Folic acid, calcium, iron, Vitamin D, Vitamin B12) were estimated to prevent 1,180 acute at a $40 million savings due to fewer acute illnesses by using nutritional supplements.

*The manufacturer is responsible for ensuring the accuracy and truthfulness of their claims and they are not approved by FDA. For this reason, the law says that if a dietary supplement label includes such a claim, it must state in a "disclaimer" that FDA has not evaluated the claim. The disclaimer must also state that the dietary supplement product is not intended to "diagnose, treat, cure or prevent any disease," because only a drug can legally make such a claim.

This part of DHSEA really shows the bias that the government has towards pharmaceutical products over natural products since natural products can be just as effective as pharmaceutical drugs at preventing and treating disease when recommended by a skilled practitioner, however, nutritional supplements can not state that they are used to treat, cure, or prevent disease.

*The final rule of DHSEA will help ensure that dietary supplements are manufactured with controls that result in a consistent product free of contamination, with accurate labeling," said Robert E. Brackett, PhD, director of FDA's Center for Food Safety and Applied Nutrition.

While DHSEA serves to regulate nutritional supplements as an industry and provides for standards of quality control, the most important part is still missing- how to choose what is the right supplement for you. In this article I provide 3 criteria that will help you as a consumer decide how spend your money wisely on nutritional supplements.

The Dangers of not choosing Nutritional Supplements wisely 

We are bombarded with advertisements and claims from nutritional supplement companies on Television, claiming that if we take this product we will lose 20 lbs in a week without changing our diet, increase our breast size, or detoxify our colon- most of these claims have not been evaluated by the food and drugs administration, have disclaimers, and are false. Some supplements will not work and will be a waste of money and other supplements can cause harm or interact with other medication. For example, Ma huang ,aka, Ephedra is a Chinese herb that was used safely and effectively in china for five thousand years to help people with colds, hayfever, and asthma. In the 1980s venture capitalists realized that this traditional Chinese medicine also speeds up metabolism and can be used as a weight loss supplement then released it to the public as a weight loss product free-for-all without FDA regulations, nor any advice to the public on how to judge this product. After a number of deaths due to sudden heart attacks, ma huang was taken off the market and banned by the FDA in 2004 and the baby has been thrown out with the bathwater because Chinese herbalist do not have access to this effective and safe remedy used for asthma anymore! The moral of this story is there are things to consider when choosing nutritional supplements and that your actions as a consumer can affect the ability of herbalists and holistic healthcare professionals from having access to natural products that can help to prevent and treat disease.

3 Rules of the Supplement Game

How do you know the supplement is going to work for YOU other than that the advertisement said it would and it worked for your uncle, sister, or friend?

Rule #1.

Individualize your plan for maximal effectiveness. We are all different in appearance and in terms of our individual needs for supplements. Individualizing your plan will reduce possible side-effects and make your supplements more effective.

Who is best able to judge what is the best supplement plan for YOU? Where do you get the most professional advice on how to individualize your plan, minimize side-effects, and maximize effectives?
The answer is Naturopathic Physicians. Naturopathic Physicians are the only type of general practitioner that is educated and experienced in using nutritional supplements and trained in clinical nutrition throughout their 4 years of medical school. All other physicians have little to no training in nutritional supplements and herbs. Your health food store clerk and aunt Mary have little to no training in what is right for you- they only know what may have worked for them (and that could have been a placebo effect) or what they read in a magazine. 
If you want the best advice as to what supplement is right for you the gold standard of care is to go to a Naturopathic physician. They will be able to determine what your individual needs are for nutrients and supplements and assess any interactions between the supplements recommended and any medication you are taking.

If you are looking for herbal medicine advice, consult with a naturopathic physician or herbalist- go to the professionals for professional, individualized, care. You wouldn't go to a dentist to fix your car, would you?

For example, you have heard how important folic acid is in pregnancy, fertility, and for hear disease. Well, if you have a genetic mutation called MTHFR genotype, taking any old folic acid will not help you. Your Naturopathic physician can do a blood test to determine if you have this MTHFR gene and also knows which type of folic acid supplement will bio-chemically allow you to absorb and use the right type of folic acid.

Individual needs are best determined by seeing a Naturopathic physician because their medical assessment of nutritional needs is what they are trained to do and will result in the most specific and effective supplement plan for you. In the same way, go to an MD if you want to get a pharmaceutical drug that is specific and most effective for your individual needs.

Rule #2 Quality

How do I judge the quality of my nutritional supplements?
In medical school, Naturopathic physicians are exposed to the traditional use, research, clinical experience of their colleagues, and highest quality supplement companies that helps them to judge what products they will use and carry in their dispensary. There is no other training or experience that comes close to this level of knowledge and experience.
The quality of nutritional supplements are judged by naturopathic physicians on many criteria, including:
- What is the active ingredient that I am looking for? For example, is it the root, leaf, or flower that is the effective part of the herb with the active ingredients?
- What dosage is effective for this individual?
- What form of this nutrient is most effective for this individual? For example, Magnesium comes in at least 10 different types.
- What are the ingredients and "other ingredients". There are many good quality supplements that make their product useless by adding ingredients, such as, glucose, talc, sucrose, additives, hydrogenated oils, and the like. In order to judge the quality of a supplement, you must know what ingredient you are looking for that is specific for what you need and what "other" ingredients may be harmful or decrease the quality of a supplement when taken on a regular basis.
- What is the reputation and mission statement of this company? In most cases, I personally visit the facility, communicate regularly with representatives of the company, and check up on their quality controls and ingredient sources. I believe that the type of person that owns the company and intention they bring into their products impacts the quality just as much as the ingredients, so I am VERY selective about what products I carry and recommend to my patients and family- only the best for them!

While MD,s are trained in knowing what pharmaceutical company, generic form of drugs, etc. is best for their patient, in the same way Naturopathic Physicians, know which supplement companies and products are best for their patients. 

Rule #3 Ethics.

Why ethics you ask? Well, if you remember the case of Ephdra or Ma Huang from earlier, you will realize that choosing nutritional supplements ethically will impact our access to herbs and supplements that are regulated by the FDA. Irresponsibly taking supplements can waste your money, ruin your health, and limit access to products that you may need in the future as a safe and effective alternative to disease.

Things to ask yourself before choosing a supplement?
Who do you I want to support? Walgreens or my holistic physician that is the expert in supplements and can best judge what products will be safe and effective for me as an individual. 
How much do I value the time, education, and advice of the person recommending this product to me?
How much am I really saving by not going to an expert and how do I feel about it?
What impact might my actions and choices have on the fate of this product being accessible to me in the future or future generations?
Who made this product and what do I know about this company?

Things to ask yourself if you are recommending a nutritional supplement or herb to someone:
Are you leading people astray, putting them in danger, or "practicing" outside your scope of experience or education?
What impact might my actions and choices have on the fate of this product being accessible to me in the future or future generations?

"Responsibility is the price of greatness" -Winston Churchill

Choosing your supplements wisely and you will feel and be great!

Take good care of care of yourself.

Sincerely,

Dr. Artemis Morris, ND, L.Ac