Multivitamin-supplements

Do You Need Supplements

The question is not whether there is room for supplementation, but rather what supplements we need and where to get the best quality to satisfy the recommended requirements.

Unfortunately, consuming a healthy diet is not enough to obtain all the nutrients we need daily. Our food is not as rich in micronutrients as it should be due to these factors:

  • Extensive farming and the use of pesticides caused mineral depletion in the soil
  • Processed and restaurant food is poor in nutrients
  • Changes in the body due to age and illness reduce nutrient absorption
  • Unripe or out-of-season produce lacks nutrients it would normally have if grown to maturity before harvesting

How Should We Use Supplements?

I recommended some supplements to a lady with severe digestive problems. Her husband, a nephrologist, looked at the supplements and told her not to take them because they were not approved by the FDA.

Let’s make one thing clear. Supplements are not regulated and do not require FDA approval before they’re placed on the market. FDA has published guidelines called Good Manufacturing Practices (GMP) that manufacturers can adhere to at will. It’s a set of requirements outlining the expectations for quality, methods of preparation, and storage conditions. However, the FDA does not inspect, guarantee, or enforce that manufacturers follow these instructions. At this time, there are no defined standards either. Any claim that a product is“certified” or “standardized”, cannot be verified and does not guarantee product quality.

Many supplements sold over the counter may not have the nutrient amount listed on the label. They may also have rice flour instead of the expected nutrient. In the worst case, they could have ingredients you might be allergic to or cannot consume (medication, caffeine, dairy). The information is not always disclosed to consumers. The FDA issues a recall when these problems are discovered, but only after a complaint is filed. It may take months before a consumer realizes that her new health problems are related to a vitamin pill she’s been ingesting.

In 2016, GNC was found liable for selling supplements manufactured by USP Labs, an indicted firm for producing supplements with harmful ingredients, and entered into an agreement with the FDA to implement better policies regarding the products they sell to ensure their safety and paid $2.25 million in settlement with the government.

In 2015 the FDA published an article on its website about  an indictment against UPS Labs.  “The indictment alleges, among other things, that USP Labs engaged in a conspiracy to import ingredients from China using false certificates of analysis and false labeling, and then lied about the source and nature of those ingredients after it put them in its products.  According to the indictment, USP Labs told some of its retailers and wholesalers that it used natural plant extracts in some of its products, when in fact it was using synthetic stimulants manufactured in a Chinese chemical factory.”(FDA.gov) (1).

In 2024, the FDA ordered the recall of two supplements, VitalityXtra and PeakMax, sold to improve male performance and energy by VitalityVita.com. Both products were tainted with sildenafil, a medication for the treatment of erectile dysfunction. In addition, PeakMax included diclofenac, a non-steroidal anti-inflammatory administered for pain and inflammation.

Sildenafil and diclofenac are serious medications and should not be taken regularly as supplements. These medications could interact with the ones the patient is already taking and cause life-threatening side effects. “Consumption of products with undeclared sildenafil may interact with nitrates found in some prescription drugs (such as nitroglycerin) and may cause a significant drop in blood pressure that may be life-threatening. People with diabetes, high blood pressure, high cholesterol, or heart disease often take nitrates. Among the adult male population, who are most likely to use this product, adult males who use nitrates for cardiac conditions are most at risk.” (USFDA)

These are just a few examples of the hundreds of products recalled every year.

Beyond obtaining high-quality supplements, you should always seek the advice of a clinical nutritionist or a functional medicine doctor before purchasing any supplements. Vitamins, minerals, and antioxidants interact with your metabolism. As clinicians, we are versed in the biochemistry of nutrition and can advise you on dosage, frequency, and best intake practices to ensure absorption and avoid toxicity.

Avoid any supplement advertised as a cure or treatment for any disease, symptom, or weight loss. We all feel desperate for a solution sometimes and it’s easy to fall prey to a promise that seems to answer our prayers. But the old saying still stands. If it’s too good to be true, walk away.

Some supplements may say “proprietary blend” on the package. Be careful when using such products and monitor any symptoms during the intake and stop immediately if you see anything strange or new, even if it doesn’t hurt.

The small guide below should help you investigate supplements before buying them.

Small Guides to Supplements

Supplements are like food; they do have a shelf life. A few precautions are necessary to  protect them from oxidation. Store supplements in a cool dry place away from the stove and light bulbs. Ensure that the lid is tightly closed to avoid oxidation. If the vitamins smell rancid, the oil has been exposed to heat or light. They will not cause any harm, but they may no longer have any potency. Another problem often seen on vitamin pills is cracking. This is often due to manufacturing techniques that use either a low-quality coating or a formula that is too dry. The supplement is still safe to take and may still be effective.

Advantages of supplements

  • When in a health crisis (deficiency, recovery from surgery or illness, reduced food intake)
  • Patient does not absorb a certain nutrient (b12, iron, folate, magnesium, etc…)
  • As part of a treatment (Gut restoration program, IBS, SIBO, etc…)
  • Ongoing health maintenance
  • Need for ongoing supplementation (vitamin D, calcium)

Disadvantages

  • No scientific evidence proving that dietary supplements solve dietary health problems or prevent illness
  • There are no standards for quality control
  • Needed quantities and side effects of certain nutrients are still unknown  
  • Absorption may not occur due to the type of pill, patientʼs condition, inappropriate intake (fat-soluble vitamins without fat, several minerals taken at the same time)
  • Supplement reps are not knowledgeable enough to advise patients  
  • MLMs encourage buyers to over-consume supplements by tying them to a membership with monthly dues
  • Misinformation: many supplements are sold for problems they don’t solve: biotin for hair; daily probiotics for digestion (taking too many regularly is harmful), BCAA for better athletic performance, a particular formula for diabetes, etc…

Risks Factors

  • People who take supplements often engage in hedonistic activities, thinking they’re getting their nutrients from supplements and don’t need to eat healthy
  • Dietary supplements are sold without FDA approval unless proven harmful
  • Side effects might be difficult to track or link to the supplements; it can take months before the negative side effects are reported to the FDA
  • Ingredients can come from anywhere in the world, exposing the patient to pollution agents, toxins, and allergens
  • Lack of control leads to supplements adulterated with prescription drug components           
  • May contain ingredients not listed on the label
  • The amount of the active ingredients can be lower or higher than the amount listed on the label
  • Many sports supplements contain steroids that endanger liver health (there have been dozens of recalls for these supplements)

Misleading Advertising

I was in a sales seminar once and the speaker said: “Remember, whatever your products or services are, you are selling only one thing: hope.” Many advertising statements are unsubstantiated. They either mean nothing or aim at deceiving the consumer into believing a false claim. Pseudo-science, buzzwords, and promises of better health are only tools to entice consumers to buy. That is not to say all advertising is bad. There are some good products and services out there that deserve praise and being an educated consumer will help you navigate the flood of advertising messages.

Then there are false or meaningless claims. Those messages use familiar words with positive associations. This is only a small list. New words and phrases are constantly added.

  • Natural. It does not mean good or safe. Products such as kava, and comfrey are all natural and yet, can cause liver injury
  • Verified. By who? Often there is no entity on the package or the one cited is a lab owned by the manufacturer
  • Certified. By who? Here again, it often is the manufacturerʼs lab. There are no details on the standards used to meet that certification nor is the certification verified by an independent authority whose responsibility is to regulate such product
  • No risk or money-back guarantee. Side effects can be experienced weeks after consumption of the product
  • Undocumented testimonials
  • Doctorʼs recommendation. Doctors and dentists on TV promoting a new medication or beauty product are often actors with white lab coats and know no more about the product than you do
  • Scientific breakthrough. Ask for peer reviews and publications (Lancet, JAMA, New England Journal of Medicine, etc…)
  • As seen on CNN. Most people know by now that this is meaningless, but I thought I’d include it here for a chuckle 
  • Impressive scientific terms: works at the cellular level, thermogenesis, patented ingredients, etc…
  • Secret ingredient. This actually can be harmful to your health
  • Increase metabolism
  • Ancient remedy
  • Used in “country X” by an obscure tribe
  • Famous doctor conducted his own research after many years of practice

All vitamins and minerals have specific and essential roles in human health. Our eyes, skin, organs, and DNA, are all dependent on the antioxidant function of these micronutrients. Reproduction, growth, strong bones, blood cell formation, and clotting cannot happen without the assistance of vitamins and minerals. These nutrients also boost your immune system when they’re abundant in the diet. A healthy diet, with minimal supplementation when necessary, is the best way to ensure an intake that is sufficient without leaning toward toxicity or imbalance. Always supplement with purpose and with the guidance of a knowledgeable health professional, preferably who does not sell any product.

If you need any personal advice, please contact us for a free consultation on what supplements are right for you.

Citations
1. https://www.justice.gov/usao-ndtx/pr/usplabs-and-corporate-officers-indicted

2. https://content.govdelivery.com/accounts/USFDA/bulletins/3c07c9b