How to Choose Quality Supplements

Have you wandered down the aisles of nutritional supplements and wondered which one to pick?

I've been asked for advice on whether a person should be taking a supplement AND how to choose a supplement that is good quality. Most people have a reason for taking a supplement and it usually falls under one of these four categories:

1. To achieve a health goal (overall health and wellness, disease prevention, etc.)
2. To fill nutrient gaps caused by medications or poor diet
3. Performance enhancement (physical, mental, or emotional)
4. Improve appearance (skin, weight loss, hair/nails, etc.)
   

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To understand why a person would take a supplement, let’s look at the first reason: to achieve a health goal. There are many people out there who are looking to increase muscle mass by using protein shakes. You can read more about this topic in the previous blog post here, which is about athletic nutrition. Some people take multivitamins to ensure their intake is sufficient, it gives them peace of mind, or it was recommended by their physician. Most multivitamins contain water-soluble vitamins (B, C), fat-soluble vitamins (A, D, E, K), and minerals. When there are too many water soluble vitamins they are excreted in the urine. You know you are dosing too high when it is bright yellow. It’s also very important to follow the recommended doses for fat-soluble vitamins (A, D, E, K) because overdosing can result in toxicity; these vitamins are stored in the body's fat and are not excreted when consumed in excess. 

The second reason people will take a supplement is to fill a gap in nutrition. Reasons for that gap can result from a side effect of a medication to a poor or inflammatory diet. This reason is mostly self explanatory, but there are also special populations who need supplementation due to alterations in the way they metabolize nutrients. One example would be those with a genetic mutation, such as MTHFR, who cannot process folate as most of the population does, and require specific forms of vitamins. MTHFR should be managed by a genetic specialist.

A third common reason people take supplements is for physical, mental, or emotional enhancement. There are herbs, or mushrooms, that can be taken as adaptogens. Herbs should be taken with caution because they can have side effects and contraindications with medications, with pregnancy, or diseases. Adaptogens are a form of nutraceutical that can aid in the stress response, helping that person to feel calm, emotionally energized, and/or physically energized. Some popular adaptogens are Schisandra, Rhodiola, Eleutherococcus, Ashwagandha, Ginseng, Chaga, and others. Protein shakes could also be considered as a physical enhancement since it can help build muscle mass. Antioxidants are taken internally, or applied topically in skincare, to decrease the effects of aging caused by free radicals. Antioxidants are found naturally in fruits and vegetables. Supplementation with antioxidants is lacking evidence on whether it prevents disease and studies are currently inconclusive. 

And the fourth common reason people take supplements is to improve their appearance. This is usually achieved by taking higher doses of vitamins B, C, E, and Omega fatty acids (fish or flax oils). Unless you have had labs performed that measured specific deficiencies of a vitamin or mineral, the evidence is conflicting for supplementation to improve the condition of hair and nails. Many healthcare providers recommend omega-3 fatty acids, such as those found in high quality fish oils, to combat inflammation in the body. It's been found in a recent study to reduce inflammatory markers in rheumatoid arthritis patients that supplement with omega-3 fatty acids.

So what makes a supplement high quality? 

A high quality supplement is made by a company that follows current good manufacturing processes (cGMP). These companies will provide access to the certificate of analysis (COA), either by posting it on their website or providing a link on their product's label. If the company states that they follow cGMP, but you do not see a link, you can contact the company and ask for it. Nutraceutical companies acquire the COA by submitting their product for testing to a third party- this ensures that the product is free from contaminants and contains the concentrations of the ingredients that they claim. Another aspect of quality that many healthcare providers look for in a supplement, is that they do not contain common allergens. Common allergens can include wheat/gluten, shellfish, dairy, egg, artificial colors, and several others.

Many chiropractors, naturopathic doctors, and acupuncturists/Chinese medicine practitioners carry high quality supplements and have vetted the products they carry. Some high quality supplements can also be found in health stores or markets. When you are choosing a supplement, look for a stamp on the label like the one posted here in this article; however not all companies will post this on the label even though they a cGMP. I recommend doing some research on a product you are thinking of buying before purchasing from a store or online.

Please consult your healthcare provider when considering adding a supplement to your routine. While many supplements can be safely taken, herbs can interact with medications and should be discussed with your prescribing physician.

References:

• Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatol Ther (Heidelb). 2019;9(1):51-70. doi:10.1007/s13555-018-0278-6
• Kostoglou-Athanassiou I, Athanassiou L, Athanassiou P. The Effect of Omega-3 Fatty Acids on Rheumatoid Arthritis. Mediterr J Rheumatol. 2020;31(2):190-194. Published 2020 Jun 30. doi:10.31138/mjr.31.2.190
• Panossian A, Wikman G. Effects of Adaptogens on the Central Nervous System and the Molecular Mechanisms Associated with Their Stress-Protective Activity. Pharmaceuticals (Basel). 2010;3(1):188-224. Published 2010 Jan 19. doi:10.3390/ph3010188
• Siddiqui RA, Moghadasian MH. Nutraceuticals and Nutrition Supplements: Challenges and Opportunities. Nutrients. 2020;12(6):1593. Published 2020 May 29. doi:10.3390/nu12061593
• Yang CS, Ho CT, Zhang J, Wan X, Zhang K, Lim J. Antioxidants: Differing Meanings in Food Science and Health Science. J Agric Food Chem. 2018;66(12):3063-3068. doi:10.1021/acs.jafc.7b05830