Are supplements good or bad?

 In 2019 77% of Americans reported consuming supplements, according to NCHS data provided by the CDC.  Even though so many Americans use them, supplements tend to be a very emotive and polarizing topic.  There is a diverse range of opinions and viewpoints. Increasingly, this situation has become even more complex because of the lucrative nature of the global dietary supplement industry. The industry was worth $35.6 billion as of 2022! 1 This growing industry has everyone wanting to get in the game, but how do you know which products are quality and which are not, and you do really need to supplement?

 What are supplements?

 By definition dietary supplements refer to vitamins, minerals, herbs or other botanicals, amino acids, enzymes, and more.  They come in a variety of forms, including tablets, liquids, capsules, gummies, and powders, as well as drinks, and energy bars. 

Some dietary supplements can help you get adequate amounts of essential nutrients, however, supplements can’t take the place of the variety of foods that are important to a healthy eating routine. 

 What about risk and safety?

Supplements are generally safe.  However, side effects can happen.  Supplements can interact with medications and other supplements in ways that might cause problems.  For example, some supplements can increase the risk of bleeding or, if taken before surgery, can change your response to anesthesia.   Some vitamins and minerals have tolerable upper limits, meaning it can cause harm to take too much of them.   

Many food manufacturers add vitamins, minerals, and other supplement ingredients to the foods you eat, especially breakfast cereals and beverages. So, you may be getting more of these ingredients than you think.   Taking more than you need can waste money, raise your risk of side effects, and cause harm. 

You should consult an educated nutritional professional before you take any supplements.  

 Quality Issues

According to the NIH "The FDA has established good manufacturing practices (GMPs) that companies must follow to help ensure the identity, purity, strength, and composition of their dietary supplements. The FDA periodically inspects facilities that manufacture supplements."  

But, the moment of truth here.    The FDA inspected 500 supplement facilities last fiscal year but that "only represents around 5% of facilities—considering there are as many as 10,000 FDA-registered facilities”.3 there is a good chance that the supplement you purchased was not included in their inspection!

Quality issues reinforce how important it is to purchase your supplements thru a qualified nutrition provider.  These providers have access to professional supplement lines and should research the companies they use.  These supplements might cost a few dollars more, but that is because they paid an independent third party to verify their products and ingredients.  Without this third-party verification who knows what you are putting in your body?

 Are supplements Regulated?

The supplement industry is not regulated the way prescription drugs are. The ingredients on the label may not accurately reflect what's actually in the supplement.  More than half of the herbal and dietary supplements analyzed by researchers contained ingredients that differed from the list on their labels4. 

Dietary supplements are not medicines and are not intended to treat, diagnose, mitigate, prevent, or cure diseases. The FDA regulations for dietary supplements are different from those for prescription or over-the-counter medicines.  "Medicines must be approved by the FDA before they can be sold or marketed. Supplements do not require this approval. Supplement companies are responsible for having evidence that their products are safe, and that the label claims are truthful and not misleading. However, as long as the product does not contain a “new dietary ingredient” (one introduced on October 15, 1994), the company does not have to provide this safety evidence to the FDA before the product is marketed"2.

Dietary supplement labels may include certain types of health-related claims. Manufacturers are permitted to say that a supplement promotes health or supports a body part or function, however, these claims must be followed by the words, “This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.”

Finally, regulation of dietary supplements is difficult because there is no global consensus on how the category of products known variously as dietary supplements is defined in different countries.

 Before you supplement 

If you decided to supplement, I urge you to speak to a qualified nutrition provider to ensure you are getting the quality product that you actually need.   Some things to keep in mind:

• Consult an educated professional before your supplement

• Get a healthcare provider’s approval before taking dietary supplements in place of, or in combination with, prescribed medicines.

• Tell your healthcare provider about your supplements before surgery. 

• Remember “natural” doesn’t always mean safe

• Ask yourself or your healthcare provider these questions:

• What are its potential benefits for me?

• Does it have any safety risks?

• What is the proper dose to take?

• How, when, and for how long should I take it?

 Want to learn more? I offer free 15-minute consultations at revivefunctionalnutrition.com.

1. Dwyer JT, Coates PM, Smith MJ. Dietary Supplements: Regulatory Challenges and Research Resources. Nutrients. 2018 Jan 4;10(1):41. doi: 10.3390/nu10010041. PMID: 29300341; PMCID: PMC5793269. 

2.  National Institutes of Health Office of Dietary Supplements.  Dietary Supplements: What You Need to Know.  https://ods.od.nih.gov/factsheets/WYNTK-Consumer/#  Updated. 1/4/2023. Accessed 2/14/2023.  

3.  Long, Josh.  FDA audits climb in FY22 for dietary supplement facilities.   https://www.naturalproductsinsider.com/regulatory/fda-audits-climb-fy22-dietary-supplement-facilities.  Published 10/12/2022.  Accessed 2/14/2023

4.  Victor Navarro, M.D., chair, hepatology, Einstein Medical Center, Philadelphia; Sonya Angelone, RDN, CLT, San Francisco registered dietitian and spokesperson, Academy of Nutrition and Dietetics; Duffy MacKay, senior vice president, scientific and regulatory affairs, Council for Responsible Nutrition; Oct. 24, 2017, American Association for the Study of Liver Diseases meeting, Washington, D.C.