Dietary Supplements: The Good, The Bad, and The Ugly

Do you need to be taking a dietary supplement?  And, more importantly, are they safe and effective?  Let’s talk about dietary supplements and their impact on human health.

We’ve all seen them, dietary supplements are prolific in almost every pharmacy, grocery, and general merchandise store.  Every vitamin, mineral, and herb you could possibly imagine can be purchased in pill form in varying dosages. Do you really need to be taking a supplement though?  And, more importantly, are they safe? There’s a lot of misinformation and general lack of knowledge out there about dietary supplements, and it’s time to set the record straight.

The basics

There are thousands of dietary supplement products on the market today, but they can be broken down (in general) to five categories: vitamins, minerals, macronutrients, herbals, and others.  Vitamin and mineral supplements include things like calcium, iron, vitamin D, vitamin C, etc. Vitamins and minerals are essential for optimal human health. We need them in appropriate quantities in order for our body to function appropriately.  Macronutrients (carbohydrates, fats, protein) are also necessary components of a healthy eating pattern. Herbal supplements, on the other hand, contain herbs and other plant materials not considered vital for human health. Examples include echinacea, Saint John’s Wort, ginkgo biloba, etc.  There are many different brands of dietary supplements, different forms (gummies, pills, capsules, oils, powders, etc.), and different dosages. Protein powders, fish oil, all the vitamin/minerals, herbals, “detox” teas, meal replacement shakes, digestive enzymes, amino acids, antioxidants, and every other item out there marketed for your consumption that isn’t a drug but also isn’t food fits under the supplement umbrella.

The Good  

Dietary supplements can help people get the nutrients they need

Dietary supplements are just that, a supplement.  If someone has a nutrient deficiency a supplement can help them get additional amounts of that particular nutrient.  While it’s always preferred to get nutrients from food, this isn’t always possible. People with very low appetites, lack of access to nutritionally dense foods, increased requirements, different medical conditions, etc. may benefit from a supplement.     

The Bad

Many people taking supplements don’t actually need them

Unless you have a deficiency, taking excess amounts of vitamins/minerals is completely unnecessary.  Like many things in life, too much is not a good thing. Best case scenario, you’ll just excrete the excess when you use the bathroom.  I know that’s not how I want to spend my money… Worst case, you could experience toxicity. Supplements can contain amounts of nutrients way in excess of what you’d normally be able to get through food alone, meaning you can actually ingest toxic amounts.  To be safe, it’s best to stick to supplements that contain 100% DV (daily value) of a nutrient or less (unless told otherwise by your dietitian or physician).

Many supplements are just completely unnecessary to begin with

Supplements like “detox” teas have absolutely zero proof that they have any type of health benefit whatsoever.  Many herbal products also have minimal, if any, research supporting their use. Despite this, supplement companies are very good at using flashy health claims to convince consumers that their products are healthy and helpful.  If something sounds too good to be true on a supplement label, it probably is. Talking to a Registered Dietitian Nutritionist can help you sort out the truth behind all the supplements on the market today and their supposed benefits.  

The Ugly

Dietary supplements aren’t regulated

Let me say that again for those who may be confused, dietary supplements are not regulated.  Under the Dietary Supplement Health and Education Act of 1994, dietary supplements are classified as a food and aren’t subjected to the same regulations as drugs.  What does this actually mean? It means that supplement manufacturers are not required to provide proof that their dietary supplements are safe, effective, or do any of the things they claim.  Essentially, they don’t have any oversight. Just look at the disclaimer they have to put on their label, “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.”  The only way a supplement can be pulled from the shelves is if it’s proven to be unsafe.  Meaning, a lot of people need to have adverse reactions to the supplement before it’s removed from the market.  Taking a dietary supplement can be kind of like playing Russian roulette–it could be totally fine, or a total catastrophe.  Either way, it’s a gamble for your safety.

Dietary supplements don’t actually have to contain what they claim

That’s right everyone, that bottle of echinacea you have (as an example) doesn’t actually have to contain any echinacea to be sold as such.  Once again, because supplements aren’t regulated nobody is testing their products to ensure they match the label. While they do have to list an ingredient list, as well as the amount of the vitamin, mineral, or herb they contain these amounts aren’t verified by an external source so nobody is going to come after them if they aren’t correct.  A supplement might contain exactly what it claims to, or it might not. It might contain the amount of that nutrient, a lot less, or a lot more. Again, it’s a gamble.

Dietary supplements can be downright dangerous.

Even assuming that a supplement contains what it claims, in the amount it claims, it still might not be safe for a person to take.  Certain supplements can interact with medications and medical conditions that people have. To be safe, you should discuss a supplement you’re thinking about taking with a Registered Dietitian Nutritionist.  You should also disclose any supplement use to your doctor. Further, if you take prescription medications, you should discuss supplement use with your doctor and pharmacist to ensure no adverse interactions are possible.

The Silver Lining

Some dietary supplements are tested for safety

The important word to pay attention to in that sentence is some.  Supplements are not required to be tested before being available to consumers.  They can, however, pay for independent third-party testing on their own (though this isn’t required by law).  There are a variety of independent testing companies out there that test supplements including, but not limited to: ConsumerLab (they do require a paid subscription though), Labdoor, NSF International, and United States Pharmacopeia (USP).  Most supplements will advertise if they’re tested since it can be very expensive to obtain this verification.  An example is the green and yellow verification symbol for USP certified supplements. Independent testing helps verify that a supplement contains what it claims and is safe.  It does not verify, however, any health claims the supplement might make. For example, if a supplement claims it “supports heart health” independent testing won’t verify that it does, in fact, support heart health.  In other words, independent testing verifies that a supplement is safe but does not verify if it’s effective.  Please note that labels like “Non-GMO”, “Whole 30 Approved”, “Kosher”, and others do not necessarily mean a supplement was thoroughly tested for safety or effectiveness.  Non-GMO, for example, means that the supplement doesn’t contain GMO ingredients, but does not necessarily verify that the ingredient list of a supplement matches what it advertises, etc.  A supplement can be Non-GMO and still be unsafe.

So now what?

Dietary supplements can be incredibly confusing, as I think I demonstrated in this post.  Here’s the steps that I’d recommend taking regarding supplements.

  1. Try food first.  Eating a variety of foods from all food groups can help ensure you’re getting the nutrients you need.  No supplement required.
  2. Consult a Registered Dietitian Nutritionist if you think you need a supplement.  They can help guide you towards an appropriate supplement if needed.
  3. Check supplement labels for independent third-party testing verification.  You can also access independent testing company’s websites (some linked above) to find tested supplements.
  4. Choose supplements that provide 100% DV (Daily Value) or less unless told otherwise by your dietitian or physician.  
  5. Avoid supplements containing herbals or other components not proven scientifically to benefit human health.  Again, consulting a Registered Dietitian Nutritionist can help you figure out if a supplement is appropriate for you.

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