The Four P's of Safe Supplements

While the FDA withholds approval of new drugs pending exhaustive (and expensive) clinical trials and safety tests, it allows manufacturers of supplements to "self-certify" their safety and it really doesn't care if they are effective. Instead it simply forbids sellers from claiming that a supplement "prevents or treats" any health condition or disease. This means that if you simply assume that supplements you buy are safe and effective, you may be very much mistaken.

Now this is not to claim that supplements should be avoided. I take them every day and I sell them to others. I have no doubt that when used as intended, as a supplement to a basically healthy diet, they can help improve and maintain our good health. But it does mean that the burden of due diligence is on you, the consumer, to know what you are getting.

So consider the Four P's (Precision, Potency, Purity and Performance) when deciding whether and which supplement products might be right for you.

 

Precision

Is what you are buying what is actually in the bottle? There are companies selling flat out bogus products but they are the exception and not the rule. A more serious concern is that the ingredients listed on the label are not actually contained in the product. This is disturbingly common. How common? Some studies have found that more than half of the supplement products analyzed contained more or less of ingredients than listed on the label or, in some cases, none of them at all.

As one especially egregious example, DimPlex weight loss supplements have been found to contain fish oil (not listed) and none of the green tea extract they claimed to contain.

Potency

Are the ingredients present in the correct amounts? Are the dosages on the label what you are getting in the product? In some cases, too little or too much of an ingredient causes no harm (other than your wasted money and false expectations). But in some cases too high a dose can cause heath problems.

Purity

It is not uncommon for supplement products to be contaminated with unsafe substances such as heavy metals, toxins, pesticides, mold, fungus or bacteria. This can be a particular problem when the supplements are manufactured in India, China or other foreign countries with few or no standards or enforcement. Unfortunately, country of origin is rarely indicated on product labels and there is no requirement for it to be.

Performance

This is more about absorption than whether or not a particular supplement does what it manufacturer claims it does. At the end of the day, it is the amount that actually is absorbed by your body that matters, not the amount in the product. Capsules and pills are held together by "binding agents" and some of these work (that is dissolve after being taken) much better than others. While pharmaceuticals are tested to determine how quickly and completely they dissolve, supplements are not.

There is no way to know how many or which specific supplement products fail one or more of these quality standards. The journal BMC Medicine recently published a study concluding that about 1/3 of supplements sold in the US and Canada contained fillers or other ingredients not listed on the label. So what is a consumer to do?

First, while you should not use price as a guide to quality, avoiding the very cheapest, low-end products is probably a good idea. This is not to say that the costliest ones are best but quality control costs money.

Try to deal with companies that have been in business for a long time. You will rarely stay in operation for 25 or 30 or more years if your products are of poor quality. If possible, choose companies that manufacture their own products rather than "job shopping" them out to others. Stick with North American or European companies that have higher manufacturing standards. In the US, the FDA has established Good Manufacturing Standards (GMP) and randomly audits companies for compliance.

Look for certification seals. The US Pharmacopeia Dietary Supplement Verification Program (USP), NSF American National Standard Certification Program and ConsumerLab Quality Certification are all rigorous standards that companies have to work hard to achieve and maintain.

Stay away from one ingredient miracle supplements. Nutrition is not that simple. Be suspicious when you see "proprietary blend" as a main ingredient. It could literally be anything.

As is sadly the case all too often, you can't take a supplement product at face value.