How to Pick Your Supplements-Michele Westendorf, MSN NP-C

Supplements are one of the fastest-growing areas of medicine. We are up to $43.4 billion in yearly revenue in the US supplement market, and the majority of Americans have at least one supplement in their home. However, most laypeople feel intimidated by the sheer number of products on the market, as well as the wide-ranging price differences for what look to be the same ingredients. The average health care practitioner and patient have a big education gap about regulations in the supplement market and how to ensure you are getting vetted and effective supplements. The Dietary Supplement Health and Education Act (DSHEA) is the main federal law governing the supplement industry. Ensuring the quality and safety of supplements is no small feat in such a large market. A study published by hepatologist, Victor J Navarro MD showed that 56% of a group of off-the-shelf herbal nutritional products were in some way mislabeled. The mislabeling varied from containing heavy metals, containing non-labeled ingredients or not containing the main ingredient. Studies like this show that, while there is a regulating federal law, there are holes that enable many poor quality ingredients to enter the market. The Clean Label Project’s Protein Monitoring Study is a non-profit independent consumer group that evaluates protein powders. They recently tested 134 powders from 52 brands and found that many of them including ones labeled “USDA certified organic” contain high levels of heavy metals, bisphenol-A, and other toxins. The American Botanical Council has issued over 41 peer-reviewed reports about adulteration and companies using different herbs than were listed on their bottles but have the same liquid chromatography in order to pass testing. These are concerning reports especially as more and more people are buying their supplements from online markets many of whom use third party vendors and therefore, is minimal quality control.
The most basic place to start to evaluate your supplements is whether or not it meets Good Manufacturing Procedures (GMPs) labeling requirements set by the DSHEA of 1994. The requirements lay out some basic specifications for identity, purity, strength, composition, and limits on contaminants. Currently, the GMP stamp only applies to the finished products and not the raw materials that went into the product. Although supplements are not prescription drugs, they contain ingredients that you are placing into your body for a specific purpose, and you want them to be safe as well as effective. Given how lucrative the supplement market is, it can be tempting for companies to take short cuts on production and ingredients sourcing. If you choose to buy your products online verify who the merchant actually is and where they source their products from. There are some practitioner-only brands of supplements (supplements that can only be obtained through a healthcare provider) on the market that are vetted and held to higher standards by health care providers than off-the-shelf products. If you decide to purchase an off-the-shelf product it should at the bare minimum have the GMP stamp. We did a general evaluation of supplement brands and then zeroed in on three of the top practitioner-only brands ( Klaire Labs, Interactive Therapeutics and Metagenics) that are able to demonstrate consistency, transparency and superior products.
We personally chose Metagenics for our office because of their dedication to research, quality and transparency. They have instigated a program they call “TruQuality.” This allows anyone to access the full unedited data from all analytical tests performed on all Metagenics products. They are also committed to evaluating where their raw materials come from. In addition to their in-house testing, Metagenics has it’s finished products independently tested by third-party labs. All products are GMO and gluten-free. We specifically evaluated their probiotics to make sure the viable counts of colony-forming units are maintained throughout the shelf life, the probiotics can survive stomach acid and arrive in the intestines. It naturally follows that a company that is committed to health is also committed to reducing its environmental impact. They have a LEED-certified building which is a Zero Water Footprint at its Gig Harbor facility and have been awarded “Recycler of the Year” by the Washington State Recycling Association.
It took 5 months of careful evaluation of not only the brands but also evaluating the literature before we settled on a set of probiotics to carry in the office.
A subsequent blog, “The Real Real,” will focus on how to ensure the legitimacy of purchased products from injectables to skincare products to supplements.