Let’s try an experiment. Off the top of your head, how many supplements can you name? There are easy ones like fish oil, vitamins, magnesium, and folic acid, so getting to 10 seems doable. How about 15? Maybe 20, if you thought about it hard enough?
If you were able to name 20, congratulations! You named just about .002% of possible dietary supplements available in the United States, according to the U.S. Food and Drug Administration (FDA). The FDA also estimates that approximately 1,000 new products are being introduced to the market every year. And if you’ve ever walked down the supplement aisle it’s easy to believe. With so many options available, how can you hope to figure out which ones are right for your health needs?
Where do we begin?
The best place to start is, obviously, your local pharmacy. Before adding any supplement to your daily regimen, it is important to review what you are taking with a knowledgeable expert. Pharmacists are specifically trained to know how both medications and supplements interact with the body and can provide guidance on a variety of options available to you.
Dietary supplements are not intended to treat, diagnose, mitigate, prevent, or cure any disease.
If you plan on doing your own research before your visit, be sure to get your information from reputable sources such as the FDA, the National Institute of Health (NIH), or other credible healthcare providers such as the Mayo Clinic. Avoid attempts to self-diagnose any health condition and work closely with your healthcare team to determine how best to achieve optimal health before starting any new supplement regimen.
How to Ensure Quality Control
It’s important to note that the FDA doesn’t review supplements for effectiveness (as it does for over the counter and prescription medications) before they enter the market. If any supplements claim otherwise, they should be approached with caution.
It is the responsibility of dietary supplement manufacturers/distributors to ensure that their products are safe and that their label claims are truthful and not misleading. ¹
The FDA has established guidelines known as ‘Good Manufacturing Practices (GMPs)’. These guidelines provide a structure that manufacturing companies must follow to help ensure the identity, purity, strength, and composition of their dietary supplements. Issues such as adding an incorrect ingredient or the wrong quantity can oftentimes be avoided by companies following the GMPs.
Additionally, several independent organizations offer quality testing and allow products that pass these tests to display a seal of quality assurance that indicates the product was properly manufactured, contains the ingredients listed on the label, and does not contain harmful levels of contaminants. These seals do not guarantee that a product is safe or effective. ⁴
Potential Risks of Supplements
There can be risks associated with starting a new supplement, especially for children, women who are pregnant and/or breastfeeding, people who are going into surgery, and those with complex health issues. However, anyone can be affected by more common issues including drug-induced nutrient depletion, or a negative interaction between a supplement and a medication. As we have stated before, it is crucial to talk with your healthcare team before taking any supplement.
Drug-induced nutrient depletion is a side-effect associated with certain prescription medications and a reason that some may start taking supplements. With repeated use, medications such as those for high blood pressure, high cholesterol, anti-inflammatory, beta-blockers, and birth control can lessen certain vitamins your body needs that can’t be elevated by diet alone.
Decreased magnesium absorption has been found in patients who take proton-pump inhibitors (PPIs), especially when the duration of use exceeds 1 year. Magnesium is an important nutrient because it is involved in over 300 enzymatic reactions—including nerve transmission, energy production, temperature regulation, muscle activation, and development of healthy bones and teeth. Magnesium also has key physiologic benefits such as blood pressure regulation, bone development, and muscular activity. Deficiency has even been associated with increased cardiovascular risk, such as hypertension, stroke, heart attack, and atherosclerosis. ²
Additionally, some supplements can have negative reactions to specific medications and could have dangerous and even life-threatening effects.
Drugs for HIV/AIDS, heart disease, depression, treatments for organ transplants, and birth control pills are less effective when taken with St. John’s wort, an herbal supplement. Depending on the medication involved, the results can be serious. ³
In addition, warfarin (a prescription blood thinner), ginkgo biloba (an herbal supplement), aspirin, and vitamin E (a supplement) can each thin the blood. Taking any of these products together may increase the potential for internal bleeding or stroke. ³
As your health changes throughout your life, it is important to continually update your pharmacist and healthcare team on the medications and supplements you are taking.
Frequently Asked Questions
Q: What forms do supplements come in?
A: To be considered a supplement, it must be ingested (not inhaled or applied topically) and can come in a variety of forms including tablets, capsules, gel caps, soft gels, powders, bars, liquids, and gummies.
Q: What are the most common supplements?
A: The most common supplements include vitamins such as multivitamins or individuals like vitamin D. Minerals such as iron, calcium, and magnesium. Botanicals or herbs such as echinacea. Botanical compounds such as caffeine. Amino Acids such as glutamine. Live microbials are commonly referred to as probiotics.
Q: What are some things to look for when reviewing supplement options?
A: This is dependent on what supplement you are reviewing. Let’s look at some examples.
Probiotics: When looking at a probiotic most people aren’t sure what CFU to go for. CFU stands for Colony Forming Units which are the number of alive and active microorganisms in one serving of a probiotic dietary supplement. The number of CFU a person needs will ultimately depend on their purpose for taking the probiotic. While most studies show that 10-20 million CFU are adequate for probiotic benefits, larger CFUs may be more suitable for individuals requiring high-intensity support.
Magnesium: There are numerous types of magnesium, such as magnesium citrate, magnesium glycinate, magnesium sulfate, and others. These all have differing applications, so it’s important to make sure you are taking the correct one for your health needs.
Vitamin D: Most people are tripped up trying to determine how many internal units (Ius) of vitamin D they need. According to the Mayo Clinic, the recommended daily amount of vitamin D is 400 international units (IU) for children up to age 12 months, 600 IU for people ages 1 to 70 years, and 800 IU for people over 70 years.
Q: What’s the difference between RDA vs DV?
A: Recommended Daily Allowances (RDAs) are recommended daily intakes of a nutrient for healthy people. They tell you how much of that nutrient you should get on average each day. RDAs are developed by the Food and Nutrition Board of the National Academies of Sciences, Engineering, and Medicine. They vary by age, sex, and whether a woman is pregnant or breastfeeding; so, there are many different RDAs for each nutrient. ¹
Daily Values (DVs), established by the U.S. Food and Drug Administration (FDA), are used on food and dietary supplement labels. For each nutrient, there is one DV for all people ages 4 years and older. Therefore, DVs aren’t recommended intakes but suggest how much of a nutrient a serving of the food or supplement provides in the context of a total daily diet. DVs often match or exceed the RDAs for most people, but not in all cases. ¹
Q: Where can I look online for information about supplements?
A: The Mayo Clinic has a resource that provides good information on a variety of supplements to reference: https://www.mayoclinic.org/drugs-supplements
If taken appropriately, supplements can be a beneficial addition to your daily regimen. Oftentimes, it is difficult to get the recommended daily vitamins and minerals from our diet alone and supplements may help improve or maintain overall health. Talk with one of our pharmacists about your health goals and if a supplement is right for you.
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