A Dietitian’s Guide to Choosing High Quality Supplements
By Rachael Bell
We’ve all been there before- walking around the supplements aisle at a drug store or supermarket thinking “where do I even start?” If you take a dietary supplement you’re in good company as so do 3/4 of Americans. Supplements can contain vitamins, minerals, enzymes, botanicals, herbs, and other ingredients. They can provide essential nutrients that may be missing from your diet, or satisfy higher needs due to a condition or metabolic imbalance. It is important that we pay the utmost attention to what we put in our bodies, especially with supplements that may have strong or even medicinal effects. Here are some factors that are important to consider when choosing a quality supplement for your health.
1. Safety and Purity:
The truth about dietary supplements is that the FDA is not required to regulate what goes into the bottle, and the claims on the outside have not been evaluated and may not be legitimate. The FDA has good manufacturing practices (GMP’s) for companies to follow that can prevent adulteration, adding too little/too much of an ingredient or unsafe practices. However, many companies still evade these regulations and use poor-quality and even unsafe materials in their products. In a 2018 study, the USDA found that out of 776 supplements tested, 97.6% had ingredients that were not listed on the label. Most of the supplements were found to be adulterated even after FDA monitoring, which is quite alarming. The types of supplements that were the most adulterated were weight loss, muscle building, and sexual enhancement supplements. Most of these were sold over the counter, but be especially wary of supplements that are sold online through unapproved pharmaceutical wholesalers (Amazon, eBay, Walmart) and multilevel marketing companies (pyramid schemes). Your safest bet is buying directly from a trusted dispensary such as Fullscript (https://us.fullscript.com/welcome/nspecialists), a reputable manufacturer, or a professional/healthcare provider.
2. Bioavailable Forms of Vitamins and Minerals
Vitamins and minerals come in various forms depending on their chemical structure. We metabolize naturally occurring forms of vitamins and minerals into their active form so they can be used in the body. For example, vitamin E has two forms: one that is naturally occurring, d-alpha tocopherol, and one that is not found in nature, dl-alpha tocopherol. D-alpha tocopherol is the active and most biologically available form of vitamin E, and our bodies cannot use the dl-alpha version well. A low quality supplement may include the dl-alpha version since it is cheaper to synthesize, however you will be paying for something you cannot use.
Some people also carry genetic variants that do not allow them to metabolize and use certain vitamins and minerals as effectively as others. Our nutrigenetics analysis can help you determine if you may need to take active/pre-formed supplements or not. It is important to read the supplement label to see what form you are ingesting, as you may not be getting as much of the product as you think. The difference between professional and consumer lines of supplements is that professional brands tend to include the most potent, active/pre-formed version so that you are getting the most out of your supplement.
3. Natural vs. Synthetic Forms
As we discussed earlier, some forms of vitamins are not found in nature, and are only created in labs. Certain dietary supplements may say their ingredients are naturally derived which means they are extracted from whole foods. However, it is important to understand that all dietary supplements are formulated in labs, and vary in the level of processing. The way to make a good choice when it comes to supplements is that those that are low quality will often use cheaper, synthetic ingredients. One example is folate and folic acid. Folic acid is a synthetic form of folate that does not naturally occur in plants or animals. It has to go through a 2 step activation before it can be used in the body. Some people who carry certain genetic variants such as in the MTHFR gene cannot efficiently activate folic acid and may even experience adverse effects from too much folic acid. In fact, high concentrations of folic acid can damage DNA and have been linked to certain cancers. It is best to find a supplement that includes folate in its natural form (“folate” or “methyl-folate”) so that you are receiving the most bioavailable form that can be used regardless of your genetics.
It can be confusing to decide what form of a vitamin to buy- there’s gummies, softgels, tablets, capsules, liquid, chewables….the list goes on and on! How do you know which one is best? Studies have found that gummies, chewables, and liquids may have less of the “important stuff” as water, sugar, and fillers used for flavor can take up a lot of space. However, they are great options for children and people who have trouble taking pills or capsules. If you want the most bang for your buck, reach for tablets as they are compressed formulations that have the potential to be most concentrated. Capsules and softgels are also excellent choices as they may be easier to digest and swallow, however their free-flowing contents may be more susceptible to oxidation, a.k.a. damage to the nutrients.
Just like we read our food labels, supplement labels are no exception. Almost all supplements contain “excipients” or additives that help to carry, bind, or preserve the product. It is important to choose supplements that limit these excipients to the bare minimum so they are not taking up precious space as fillers. You will also notice that professional grade supplements avoid excipients that are known to cause harm or decrease the bioavailability of the nutrients. These include artificial preservatives, flavors, colors, hydrogenated oils, and substances such as titanium dioxide, magnesium stearate, and magnesium silicate that may decrease absorption and cause damage to the digestive tract.8
As you can see not all dietary supplements are created equally. When it comes to our health, there is nothing more important than making sure you are putting only the best stuff inside your body and leaving the “junk” out. The dietitians at Nutrigenetics Specialists are happy to review dietary supplements you are considering or have already purchased to help guide you. Contact us today and we will help you choose professional grade products that are best for your needs. https://www.nutrigeneticsspecialists.com/contact
Unapproved pharmaceutical ingredients in dietary supplements. Reactions Weekly. 2018(1725):12 https://search.proquest.com/scholarly-journals/unapproved-pharmaceutical-ingredients-dietary/docview/2137395304/se-2?accountid=12390.