In my day-to-day practice, I see many patients who are extremely ill. It’s not uncommon for at least one patient a week to come into my office with shopping bags full of different products purchased from infomercials, Amazon, Costco, or a local drug store. Seeing this happen over-and-over again is concerning, since many products really aren’t what they claim to be. Because vitamins, herbs, and natural supplements aren’t regulated by the Food and Drug Administration (FDA), many products that are available over-the-counter (OTC) are poor quality and in some cases, can even be more harmful than helpful. In addition, many labels have ambiguous instructions concerning administration. It’s not uncommon to see something like, “take 1-2 capsules, 2-3 times per day, or as instructed by your health care provider.” Huh? What does that mean?
When considering different supplements to support your health, here are few things to think about…
1. Just because a product is labeled as “natural,” it doesn’t necessarily mean it’s safe or that the recommended dose is what’s right for you. Although most vitamins and supplements have a Recommended Daily Intake (RDI), a supplement should really be dosed according to therapeutic intention. Some vitamins and minerals, (such as vitamin D, vitamin B12, and magnesium, to name a few) should only be dosed based on the level that can already be detected in your blood. Consuming these products in a dose higher than what’s right for you can be harmful and cause a variety of unpleasant side effects just like pharmaceutical medications. Therefore, “doubling up” on vitamin B12 just because you need a boost of energy is not always a good idea.
2. Mixing various vitamins, supplements, medications, (and even foods) together, without knowledge about how they will react or interact, can be dangerous. Do you remember being a kid and mixing baking soda and vinegar in science class, then waiting for the reaction? Using this example, we can see that even the most benign substances can create a strong chemical reaction. Did you know that grapefruit juice interacts with a variety of different pharmaceutical medications because it inhibits the production of Cytochrome p450, an enzyme responsible for drug metabolization? If taken within 24 hours of certain medications, grapefruit juice can cause elevated levels of those medications in the blood, making them much more potent than intended.
3. Timing of consumption is also something to consider. All vitamins, supplements, and herbs have a mechanism of action, a describable manner in which they work. For example, some supplements are anabolic. They cause a building-up effect in the body. Other supplements are catabolic. They cause a breaking-down effect in the body. It is important to avoid taking supplements that have two opposing mechanisms of action at the same time. Doing this can negate the effectiveness of each supplement and can make you very ill.
4. Despite appealing product labels and clever marketing tactics, many products do not contain the high quality ingredients that they claim they do. Vitamins, supplements, and herbs are not regulated by the FDA. While there is a regulatory standard called the Current Good Manufacture Practices (CGMP) and a number of labs that measure quality, efficacy, and safety, many OTC supplements do not go through external methods of quality control. In addition to poor quality ingredients, OTC products can contain various contaminants, artificial fillers and preservatives, heavy metals, and/or toxic agents.
It’s easy to get overwhelmed in choosing supplements that are safe, effective, and high- quality. As a healthcare provider who uses vitamins and supplements as a core component of treatment, I do not recommend that patients try to manage medications, vitamins, and supplements on their own. If you’re taking more than a multi-vitamin and one medication per day, I strongly recommend consulting with a natural medical provider who has extensive knowledge about vitamins, supplements, and interactions. Remember, most medical doctors (MDs) are not trained in vitamins, supplements, or nutrition. If you are seeing multiple doctors for different complaints, it is not uncommon for medications and potential interactions to get overlooked. Having a specialist help you create a medication and supplement chart with dosage, time of day to be taken, and special instructions can be helpful.
In addition, it’s extremely important to use only the best quality products available, known as “pharmaceutical-grade” products. These products go through stringent quality control measures regarding processing and purity, established by the US Pharmacopeia (USP). All ingredients must be verified by an outside agency to be at least 99% pure. Random samples are tested throughout the year to ensure that quality control and purity is maintained over time. Pharmaceutical grade products are only sold by healthcare providers so that patients can be monitored and expected therapeutic outcomes can be achieved.
In practice, I only use pharmaceutical grade products with my patients. There are a number of manufacturers I recommend depending on the actual vitamin or supplement. I use a variety of sources to cross-check the highest rated ones so that I’m confident when prescribing them.
If you are concerned about the quality and/or administration of the vitamins and supplements, take the time to seek the help of a licensed professional to assist you. Don’t let the vitamins and supplements that are supposed to be optimizing your health cause more harm than good.