Why Supplement Quality Matters
Let’s chat supplements, shall we? I always ask my clients to send a list of any supplements they are currently taking, with brand details and/or a photo of the label so I can evaluate. More often than not, there are opportunities to make meaningful improvements to the quality - either the nutrients are in a poorly absorbed form, or the product is loaded with “other ingredients” like hydrogenated oils, dyes, artificial sweeteners, allergens like wheat or soy, etc. I make sure to spend time in our sessions going through each supplement and educating them on why it is important to choose high quality products. Without doing heaps of your own research, choosing the best ones is easier said than done as the supplement industry is a bit like the wild, wild west! In this post, I will address why all supplements aren’t created equal, and provide the information you need to make informed purchasing decisions.
Before we get into the nitty gritty of supplement quality, it’s worth touching on why you need supplements in the first place! In an ideal world, we would get all our vitamins, minerals, and phytonutrients from the food we eat. Unfortunately, even with a “perfect” diet (whatever that is!), this is nearly impossible. Why?
Why do we need supplements?
1. Poor quality soil – a plant is only as nutritious as the soil it is grown in. Modern day industrialized agricultural practices cause a decrease in nutrient content.
2. Nutrient depletion – there is a decline in nutrient levels with storage, transport, and processing/refinement.
3. Environmental toxins – we are exposed to a deluge of environmental toxins every day (pesticides, xenobiotics, etc.) which increase oxidative stress in the body. Our environment has changed drastically in the last 100 years and our bodies simply require more care than in the past. Supplements provide antioxidant power to support detoxification and combat free radical damage.
4. Inadequate fruit and veggie intake – let’s be honest, most people don’t get the USDA recommended amount of 3 cups of vegetables and 2 cups of fruit daily. Research shows that only 11% of us actually reach this daily goal.
5. “Frankenfoods” – trans fats, artificial additives (preservatives, flavors, colors, etc.), hormones, antibiotics, pesticides, etc. are nutrient robbers!
6. Medications – many people take pharmaceutical and over-the-counter medications that deplete nutrients in the body (oral contraceptives, Metformin, statins, etc.).
7. Biochemical individuality – each person is biochemically unique, so one size does not fit all. Everyone needs vitamins and minerals, but in differing amounts based on their biochemistry, genetics, nutrition, etc.
8. Gut health – many people have suboptimal digestive function which interferes with proper nutrient absorption.
9. Chronic stress – we’re a totally stressed out society, and chronic stress depletes your body stores of vitamins and minerals (e.g. B vitamins, vitamin C, zinc and magnesium) more rapidly.
Nutrient-depleted food, high-stress lifestyles, toxic environments, and gut issues can all make it difficult to get the necessary nutrients from food alone. I know this sounds a bit bleak, but it does not mean that we should give up on eating well. It means that we should choose the highest quality foods to nourish our bodies AND we should use nutritional supplements as a way to round out a nutrient-dense real food diet.
Micronutrients (aka vitamins and minerals) are essential to our biochemistry and metabolism. They work as catalysts to stimulate normal chemical reactions in the body; help in the production of enzymes, hormones, energy, new cells and DNA; protect genes from damage; turn on good genes and turn off bad genes. Without them, these normal biological processes wouldn’t run smoothly.
Research shows the average person has deficiencies in several important micronutrients (vitamin D, folate, zinc, magnesium and iron). These micronutrients are found in food, but you may not be able to eat your way out of a deficiency. Let’s take vitamin D for example. You’d need to eat five 6-ounce fillets of wild sockeye salmon a day to get 5,000 IU, which is the often-recommended dose for low serum vitamin D levels. Unless you are a grizzly bear, that would prove to be quite challenging! Hence, a vitamin D supplement to the rescue.
Supplement quality is key
Supplements are not regulated in the same way as food and pharmaceutical drugs. While the FDA regulates the dietary ingredients and the finished products, supplements do not need to be approved by the FDA in advance of being sold. The FDA only takes action against an adulterated or misbranded dietary supplement after they reach the market.
Under the Dietary Supplement, Health and Education Act (DSHEA), it is up to the supplement manufacturers to screen for quality, safety, and label integrity (i.e. what is on the label is actually what’s in the bottle). Some supplement manufacturers aren’t doing this, and inadvertently put untested and contaminated ingredients into pills, along with binders, fillers, allergens, dyes, etc. Not to mention, they can use cheap, synthetic, and poorly absorbed forms of vitamins and minerals to sell products at the lowest possible prices at your local drug store/megamart, or on Amazon. Fortunately, reputable manufacturers do exist, who not only adhere to the DSHEA statute, but impose even stricter standards and use only the highest quality, active and natural forms of nutrients with optimal bioavailability (described below). Not surprisingly, these high-quality formulations are often more expensive and, in many cases, are only sold through qualified practitioners.
Not all supplements are created equal
As you learned above, in the supplement industry, product quality is all over the board. In my opinion, you’re better off taking nothing than wasting money on low quality supplements loaded with synthetic nutrients and/or toxic additives!
There are three characteristics to pay attention to: grade, form/bioavailability and delivery method.
Grade
I use and recommend only pharmaceutical-grade supplements that meet the following criteria:
≥99% pure – i.e. must not contain binders, fillers, dyes, excipients, etc.
free of allergens - e.g. wheat, gluten, eggs, peanuts, GMOs, etc.
raw ingredients are 3rd party tested for quality and purity
ingredients are in most bioavailable forms for enhanced absorption
manufactured in FDA-registered facilities that follow Certified Good Manufacturing Practices (cGMP)
Most pharmaceutical-grade supplements are available without a prescription, but only through licensed health care professionals who understand the potency and efficacy of the supplements they’re recommending.
Form/Bioavailability
It is important to choose supplements whose ingredients are in the most bioavailable forms. Bioavailability is a measure of the amount of an ingested nutrient that is absorbed and made available to the body for metabolic use. Here’s an example: your body knows exactly what to do with the folate found in asparagus as it is in the tetrahydrofolate form. When you take a low-quality supplement with synthetic ingredients, the folate will likely be in the form of folic acid. Your body has to work a lot harder to convert folic acid into usable folate for absorption. And, for people with MTHFR genetic mutations, their bodies are not efficient at doing so and, thus, the folic acid gums up the works! Alternatively, pharmaceutical-grade supplements use the most bioavailable form of folate (L-5-methyltetrahydrofolate), so your body can easily metabolize and absorb the nutrient!
Delivery Method
The best delivery method depends on the supplement, but I generally recommend liposomal, powder, and capsule formulations for highest bioavailability. Here’s a quick breakdown:
Liposomal – the nutrient is attached to a phospholipid molecule that allows it to be easily absorbed by your cells.
Powder – typically fast absorbing. Good form for “bulky” nutrients like magnesium that require a larger amount to meet recommended servings.
Capsules - easily broken down during digestion so the nutrients can be absorbed. Capsules protect ingredients from moisture and hide unfavorable flavors and odors. For example, the herb ashwagandha tastes like dirt so I prefer to take it in capsule versus powder!
Tablets – often take the longest to break down and thus the nutrients are harder to absorb.
How do you find a quality supplement?
I’ve vetted them for you! I believe it is important to select supplements from companies who:
Use only the highest quality raw materials in manufacturing pharmaceutical-grade supplements.
Meet or exceed Good Manufacturing Practices (cGMP) standards, the regulations set forth by the FDA.
Are certified by the NSF, the most respected independent product testing organization who confirms what is on the label is in the product and that the product contains no unsafe levels of contaminants.
Require regular third-party testing to verify stringent quality and purity standards are met.
Have dedicated distribution facilities with quality controls in place (no hot sweaty fulfillment centers which degrade the potency and efficacy of products!)
For these reasons, I only partner with reputable providers that offer high-quality supplements. My favorites are: Fullscript and WholeScripts.
If you are not purchasing through verified sources, be wary of counterfeits! I won’t get into that here, but if you’re interested in learning more about fraudulent supplement sales through online retail sites, here’s a recent study in JAMA, and here are a few articles: The New York Times, Boston Magazine, and Wired.
If you’re considering buying supplements but unsure of the brand, you can look it up on the NSF Certified Products and Systems website to see if it has this prestigious certification. Also, always check the ingredients list, making sure to look at the “other ingredients” section as this is where the sketchy stuff (e.g. additives, fillers, binders, artificial colors/flavors, etc.) can hide!
Where to start?
A healthy diet is the cornerstone of good health, but supplements also play an important role. Here’s a blog post that outlines five foundational supplements which are a great place to start.
One thing I will caution against is starting too many supplements at once without supervision from a practitioner. If you start taking 5 new supplements at once, it will be difficult to tell what is working. Additionally, while unlikely, if you do have a negative reaction to one of the supplements, you won’t know which one caused it. Therefore, I recommend starting one at a time. Give each new supplement a week or two before starting the next.
Pharmaceutical-grade supplements cost more than what you’d find at GNC, CVS, Whole Foods, etc., but are guaranteed to be pure and of the highest quality. You get what you pay for! If cost is a concern, consult with a nutritionist to determine your supplement needs and prioritize the ones that will be the most useful to reach your health goals. It is more beneficial to take a couple of high-quality supplements that a bunch of poor-quality ones.
Need more support with customizing your supplement plan?
It is important to understand your individual needs before starting supplements. Your doctor can order lab work to determine if you have any overt nutrient deficiencies, while a nutritionist can…
Assess your nutritional status to determine likelihood of inadequate or excessive intake of vitamins and minerals
Evaluate the pros and cons of supplementation given your nutritional and health status
Evaluate the safety of a supplement given the form, dose and its potential for interaction with food, other dietary supplements, and medications
If you’re interested in consulting with a holistic nutritionist, Keenist has you covered! Book a session here.