image of many pills and supplements

Intro to Supplements

Even though vitamins, minerals and other nutritional supplements have been commercially available for decades, these products are still shrouded in a certain degree of uncertainty. Consumers tend to fall into three camps when it comes to supplementation — those who view supplements as inherently useless and even dangerous; those who firmly believe in the health benefits of every supplement sold at the grocery store; and those who periodically take a multivitamin without putting much thought into it, simply “for good measure.” Simply put, most people do not have a comprehensive understanding of the potential benefits of supplementation, nor the potential risks.

This is not entirely surprising, as the supplement industry is largely unregulated, which allows supplement manufacturers to market their products with overblown claims about effectiveness, even when clinical trials have shown that certain supplements are entirely useless.[1] And while manufacturers are technically not allowed to claim that supplements can prevent, treat, or diagnose medical conditions, they can still advertise the supposed nutrient contents and potential positive effects of their supplements on various body parts and bodily processes, such as the immune system, bone health, and bowel regularity. Of course, some companies in this unregulated industry flout the rules entirely by making unsubstantiated claims about the medicinal properties of their products.[2]

Furthermore, the lack of FDA regulation means that some supplements may contain unhealthy or even dangerous ingredients such as heavy metals, pesticides, and even prescription drugs, while supplement packaging can be woefully sparse when it comes to listing side effects and interactions with other medications. Conversely, not all supplements contain the ingredients advertised on their packaging.[2, 3] Prescription medications are required to undergo independent testing for safety and effectiveness and are closely regulated by the FDA; supplements are not. In fact, a company can introduce a new supplement directly to consumers as long as it contains “a vitamin, a mineral, an herb or other botanical, an amino acid, a dietary substance for use by man to supplement the diet by increasing the total daily intake, or a concentrate, metabolite, constituent, extract, or combinations of these ingredients.”[2] This means that under the guidance of the Dietary Supplement Health and Education Act of 1994, just about anything can be sold as a supplement. The burden of proof is actually on the FDA to prove that such products are unsafe before they can be taken off the market, a process that can take years to complete.[2] And because supplements are not classified as medications, most can be sold without a prescription, even those containing active ingredients that could cause allergic reactions or interfere with the safety and usefulness of other medications. It has been well documented that certain supplements are unsafe for women who are pregnant or breastfeeding, while others are known to exacerbate existing health problems.[2]

Yet the fact that there are shortcomings within the supplement industry itself does not mean we should discount all of the research that points to the benefits of supplementation, especially when approached on a bespoke, individually-tailored basis as a way to complement a healthy diet and an active lifestyle.

In an ideal world, we would receive all of the micronutrients our bodies require from food, water, and sunlight. However, in the real world, this is not the case, due in part to the fact that the foods we eat have fewer nutrients than they did in previous generations. Researcher David Davis of Texas University noted that between 1950 and 1999, the proportions of 13 different nutrients decreased in nearly all vegetables, as well as in chicken, milk, eggs and other agricultural products.4 Thus, even among healthy people who get regular exercise, are exposed to moderate amounts of sunlight, and consume a balanced diet, most of us are not getting enough of certain nutrients. A large proportion of Americans fall short of the Daily Recommended Intake for vitamins and minerals such as Vitamin D, Vitamin E, potassium, magnesium, and chlorine.[1]

Nutritional supplements can have a major role to play in improving our overall health by “filling in the gaps” in our nutrient intake. Besides the nutrient deficiencies in the modern diet, other factors such as stress, exercise, and pregnancy can increase the amounts of various nutrients that we need to ingest in order to stay healthy. By thoroughly researching what specific micronutrients we may lack due to factors such as lifestyle, gender, age, and geographic location, we can then pinpoint the safest and most effective ways to supplement a healthy diet with vitamins and minerals.[3]

Americans now spend $17 billion per year on nutritional supplements, but not all of those supplements are created equal.1 And, unfortunately, the solution to micronutrient deficiency is not as simple as popping a daily multivitamin. Although there is some research suggesting that multivitamins can be effective in preventing certain medical conditions and even combating signs of aging, multivitamins do not contain sufficient amounts of each and every nutrient in which you might be deficient.[1, 6] As mentioned above, different people have different micronutrient needs based upon gender, age, geographic location, lifestyle factors, and existing medical conditions. Beyond this, different multivitamin brands contain ingredients of varying levels of quality — as is the case among different brands of all types of nutritional supplement. Many multivitamins, especially those that are less expensive, do not contain the most bioavailable forms of each micronutrient, meaning that the body is unable to properly extract what micronutrients they may contain.[2]

There are many other factors to consider when supplementing with vitamins and minerals. Many minerals compete for the same absorption sites within the body, so taking a multivitamin that includes all of them at once means that you probably won’t be absorbing some at all. The bioavailability of certain nutrients can also be dependent on the foods you eat alongside your multivitamin — some micronutrients are water soluble, while some are fat soluble. For example, some micronutrients need to be taken at the same time as food, but should not be combined with coffee.[3] There is also evidence to show that some synthetic supplements are much less bioavailable than food-based supplements. The body is better equipped to absorb nutrients from food sources and food-based vitamins than it is to process isolated molecules from synthetic supplements.

This is all to say that while multivitamins can play a positive role in improving micronutrient intake and correcting certain dietary deficiencies, they are usually not as effective as individual vitamin or mineral supplements, and special care should be taken to choose a high-quality brand. As with all supplements, consumers should always read instructions about what time of the day they should be taken, the correct dosage, and with which foods they should or should not be combined.[3]

So, take your health into your own hands. Do your own research. You can begin here by reading our in-depth profiles of several key micronutrients and our reviews of various nutritional supplements. Besides recommending specific products that have been vetted through our rigorous process, we have also made recommendations about food sources that are high in various micronutrients, as well as the best ways to get certain nutrients from other sources.

Above all, we try to help you be safe and smart about which supplements you purchase and consume. We look at thousands of pages of scientific research and use sources like PubMed, and Natural Medicines Comprehensive Database. Lastly, to ensure that you are purchasing a high-quality product with accurately-labeled ingredients and proper guidance about health warnings and contraindications, we make sure that the products we recommend has been verified by the United States Pharmacopeial Convention. The USP is a non-governmental, not-for-profit organization that sets the standards for labeling, quality control, and manufacturing processes not only for nutritional supplements but also for over-the-counter and prescription drugs. Moreover, their standards are enforceable by the FDA.

The current state of research is such that most likely some supplements can contribute to a healthy lifestyle, support long-term wellbeing, and potentially prevent some future health problems. Many people in the US are deficient in certain vital micronutrients to their detriment.

Whatever path you choose to follow with your supplementation regime, we at HealthAnchor want to make sure you have access to the best products that you are looking for.

References:
1 Vorland, Colby. “Multivitamins: Is the Debate Over?” American Society for Nutrition. January 2014. http://www.nutrition.org/asn-blog/2014/01/multivitamins-is-the-debate-over/.
2 “Confusion in the Supplement Aisle: How to Help Consumers Select Dietary Supplements.” Natural Medicines Comprehensive Database. http://naturaldatabase.therapeuticresearch.com/ce/ceCourse.aspx?s=ND&cs=&pc=07-33&cec=1&pm=5.
3 Klatt, Kevin. “Controversy Over Multivitamins.” Naturevolve. December 2013. http://nutrevolve.blogspot.co.uk/2013/12/controversy-over-multivitamins.html.
4 “Tale of Tasteless Tomatoes: Why Vegetables Do Not Taste Good Anymore.” Calm Science. December 2015.
http://calmscience.net/2015/12/11/tale-of-tasteless-tomatoes-why-vegetables-do-not-taste-good-anymore/.
5 Huber, Colleen. “What to Look For in a Vitamin.” American Association of Naturopathic Physicians. http://www.naturopathic.org/content.asp?contentid=35.
6 Xu, Qun, Christine G. Parks, Lisa A. DeRoo, Richard M. Cawthon, Dale P. Sandler, and Honglei Chen. “Multivitamin use and telomere length in women.” The American Journal of Clinical Nutrition. March 2009. http://ajcn.nutrition.org/content/89/6/1857.full.
7 “USP Verified Daily Supplements.” U.S. Pharmacopeial Convention. http://www.usp.org/usp-verification-services/usp-verified-dietary-supplements.