If you are found to have a true vitamin or mineral deficiency that’s diagnosed by a doctor, have a medical condition that requires supplementation, or can use a supplement to help manage side effects during cancer treatment as monitored by your physician (start with my intro to supplements post if you haven’t already) you may ask yourself where to start in terms of a good quality supplement. There are so many supplements on the market and not all are created equal. How do I know which one’s are safe?
One major problem with the supplement industry is that the Food and Drug Administration “is not authorized to review dietary supplement products for safety and effectiveness before they are marketed”. Wait, what?!?! Is this true? Yes, I know it’s hard to believe, but the federal law does not require supplements to be proven safe or effective to the Food and Drug Association’s (FDA) satisfaction before they are marketed. Under current law, supplements are assumed to be safe until the authorities can prove otherwise. They aren’t pulled from shelves until after serious injuries occur. The reason for this is that the FDA simply doesn’t have enough manpower to enforce current laws, so it takes significant consumer harm and backlash to get investigations underway for potentially harmful products. By the time that happens, innocent people are affected – here’s one example of liver damage from supplements.
This leaves a lot of room for bad products to get in the market. You will often see claims made about specific supplements or ingredients in supplements, which can be tempting to trust. However, for some claims made on the label of dietary supplements, the law does not require the manufacturer or seller to prove to the FDA’s satisfaction that the claim is accurate or truthful before it appears on the market. Once dietary supplements are on the market, the firms must report to the FDA any serious adverse events that are reported to them by consumers or health care professionals. In general, the FDA’s role with a dietary supplement product begins after the product enters the marketplace. That is usually the agency’s first opportunity to take action against a product that presents a significant or unreasonable risk of illness or injury, or that is otherwise adulterated or misbranded.
What’s worse is that supplements can contain cheap fillers that do not serve as a therapeutic function (which may include contaminants) and may not contain what’s listed on the label at all and we may have no way of knowing what they are using. This could be dangerous for people with food allergies, which can result in adverse reactions. I know this is probably shocking and may cause some disbelief as I was surprised when I learned the same. Adam Conover does a great job at explaining this in a short clip on his show Adam Ruins Everything. He debunks many common held beliefs on all types of topics and uses reputable scientific research that’s cited if you’d like to read more about it after watching his clips.
So what should I look for?
So now that you know all of this, the silver lining is that you don’t have to be discouraged into thinking that you cannot trust any of the supplement companies. There are a few tools that you can use to determine what is the best supplement brand for you. Some supplement companies voluntarily choose to go through a third party company verification process for assurance of what’s on the label is actually in the bottle, it assures of product consistency, quality, purity, and potency of their product. Third party companies are not associated with the manufacturer and they have the expertise to assess quality in a non-biased manner. The United States Pharmacopeal Convention does just that. You can look for the USP logo on supplement labels to know which one’s have gone through this process or check out their website. USP standards are recognized in over 140 countries.
The USP logo means:
- It contains the ingredients listed on the label in the declared strength and amounts.
- Doesn’t contain harmful levels of specified contaminants.
- It is made according to USP Good Manufacturing Practices (GMP) and FDA’s GMP, using sanitary and well-controlled processes.
- Will breakdown and dissolve within a specified amount of time so that the active ingredients can be released and absorbed in the body.
- Each year USP will conduct a facility audit and own surveillance. They will pull products off shelves and test them randomly.
- Makes sure that the supplements are meeting acceptable limits for contaminants such as heavy metals, pesticides, dioxins, furans, PCB’s, and microbes.
- USP’s Good Manufacturing Practice (GMP) audits go far beyond the FDA’s GMP facility audit.
*Of note, something that the USP label or other third party labels don’t tell you is if the product is actually effective and what it does is appropriate for the treatment that you seek.
Another third party company that uses similar testing to determine quality supplements is Consumer Labs. This company randomly buys products from stores, catalogues, and multilevel marketing companies and tests them. If they pass, for a fee, they can display the “Approved Quality Seal” and have to continue to be subject to periodic testing to maintain the logo to ensure quality and safety. You can make suggestions for brands to test for if there are any you are interested in.
If the supplement brand I like is not third party tested, what can I do?
Sadly, there aren’t many supplement companies that have chosen to go through this type of process. If there is a brand that you like to take and they haven’t gone through this process, I would encourage you to contact them directly and encourage them to do so. Since they are a business it is in their best interest to keep their customers happy and to provide them with what they want if enough people demand it. Some supplements may be a little more expensive than other’s if they have gone through this process as it costs approximately $400-$600 for a single nutrient in a supplement to be tested by a third party company. A single multivitamin can cost up to $12,000 to have it tested, which is important to keep in mind if your supplement costs a little more and is USP, NSP, or Consumer Lab verified.
If you see any of these three third party company logos listed on a bottle then you can feel much more confident with your purchase:
In conjunction with looking into a supplement brand that you like to take or are curious about, that may or may not have these third party tested labels, you also want to assure that what you are purchasing has the greatest potential to work and not provide harm by having the manufacturer supply you the following on their website or upon request:
- The best, current clinical research supporting the use of the active ingredients in the supplement, that is evidence based and in a peer reviewed journal, that you can read in it’s entirety. If the research provided is done by the supplement company itself and is not published in a peer-reviewed journal this is considered a poor form of quality research and should not be trusted. Peer reviewed means that other scientists have reviewed the research and agree that it’s statistically significant, the scientific methods are sound, and that the research is quality. Some companies may have hired a single scientist on site, but other scientists outside of that company should still review this as it can be a conflict of interest otherwise. Also if the company doesn’t cite the research studies specifically or have a link to their studies and claim they have done their own research and are vague about it then this is not to be trusted until they can prove otherwise.
- Show the data supporting safety and efficacy, which includes long-term empirical data.
- Identify proper ingredient dosage and forms matched to positive outcomes from clinical data.
- All dietary supplements, products, and powders should be manufactured in an FDA registered pharmaceutical facility in compliance with Good Manufacturing Practices.
- Ingredients should be tested for purity, potency, and delivery from raw material to finished product.
It might take a little time to do this, but it’s worth it to be ensured quality and safety. Most of us are creatures of habit and when we find something we like we tend to stick with it. Once you figure out what can be trusted then you can keep taking that particular brand and not have to worry about researching supplements all the time. It is good to check every few years to make sure that nothing has changed. Ultimately the supplement industry is complex and hard to decipher for almost all of us unless you use some of the resources provided for you above. I encourage you to do a little research so that you can feel comfortable with the decision you make. Remember, these supplement companies are a business, and they don’t always have your best interest at heart…it’s important to learn the tools to protect yourself and your wallet.
For more updates, you can follow Survivors’ Table on Facebook. Thanks for joining me on this journey! – Danielle