We recently sat down and asked Sharyn Reinhold, a Clinical Nutritionist, to answer a few common supplement questions. Find out what she had to say about supplement regulation, the need for nutritional supplements, quality and more!
Q: What is the difference between nutritional supplements and prescription medications?
A: According to the FDA, it defines a dietary supplement as “a product intended for ingestion that contains a dietary ingredient intended to add further nutritional value to (supplement) the diet.” A “dietary ingredient” may be one, or any combination, of the following substances: a vitamin, a mineral, an herb or other botanical, an amino acid, a dietary substance for use by people to supplement the diet by increasing the total dietary intake, a concentrate, metabolite, constituent, or extract. Prescription medications are defined as “substances intended for the diagnosis, cure, mitigation, treatment, or prevention of disease.” They are “prescribed by a doctor, bought at a pharmacy, and prescribed for and intended to be used by one person.”
Q: Does the government regulate supplements?
A: Yes, the Food and Drug Administration regulates supplements under the Dietary Supplement and Health Education Act (DSHEA) of 1994. New regulations regarding the introduction of new dietary supplement ingredients to the market are even more stringent in some ways than those overseeing the pharmaceutical industry. As a part of the oversight by the FDA, it requires supplement manufacturers to follow Good Manufacturing Practices (GMPs). GMPs are a set of steps companies must follow to ensure pure, safe and effective products. Many companies also seek additional quality certifications through independent agencies.
Q: Are supplements really needed if I eat healthy?
A: While eating a well-balanced and nutrient-dense diet can go a long way in preventing nutrient deficiencies and warding off many chronic diseases, there are many other factors that contribute to someone’s nutritional status. Certain disease states and stress can deplete nutrients, making it difficult to receive adequate amounts through foods. Also, the nutrient value of the food supply has decreased overall, because of things like over-farming, storage and transportation of foods, and the use of glyphosate on crops. This may be why sub-optimal levels of iron, vitamin D, and magnesium are now common even among those who are considered generally healthy. Apart from the consideration of whether to supplement with vitamins and minerals, someone may use other types of dietary supplements (i.e. herbs, amino acids, plant extracts) as a more natural alternative to treating various health concerns.
Q: Can I take supplements if I’m already on prescription medications?
A: Yes, it is possible to safely take both supplements and prescription medications. However, there are interactions that can occur, depending on what you are taking. If you already take medications, I highly recommend talking to a professional or doing research on interactions before starting any supplements. Additional information on interactions can often be found through a pharmacist, on prescription package inserts, or through certain trusted medical or nutrition websites.
Q: Are all supplements the same/does brand really matter?
A: No, all supplements are NOT the same and yes, brand really matters! Dietary supplements can contain anywhere from 10% to 90% raw materials depending on the quality. Pharmaceutical grade is the gold standard for supplements. These can be found through healthcare providers and certain online distributors. Potential problems with poor quality supplements include contaminants or hidden allergens, and low potency. When purchasing over-the-counter supplements, look for those that are third-party verified and research individual companies to see what their quality standards are. Consumer Labs is a great resource for learning which over-the-counter supplements live up to their claims.
Q: Is there a certain form that’s better (capsule, powder, liquid, etc.)?
A: Supplements can come in many forms, including tablets, liquid, capsule, gel caps, powders, and even creams. The succinct answer is this – if you stick to pharmaceutical grade supplements, the companies that make them know which form is best for which type of supplement. When buying over-the-counter supplements, avoid tablets and also gel caps/liquids that say “refined,” especially for multi-vitamins and oils (i.e. fish, flax, etc). Some companies use heat during processing, which can destroy certain nutrients. Also, be cautious of store-bought powders, which may be more likely to contain fillers and binders. Aside from those considerations, it just depends on your preference for taste, texture, and swallowing pills. Capsules (opened up), powders, and liquids are a pleasant option for those taking multiple supplements, since it can add them into beverages or smoothies.
Q: Should I take my supplements at a specific time of day?
A: It just depends on which supplements and medications you take. It’s best to get the guidance of a healthcare professional on this, particularly if you take both medications and supplements, because there are many considerations when deciding when to take what. One example is probiotics. It’s helpful to take them while on a course of antibiotics (for gut health), but taking them at the same time of the day can make the antibiotic less effective. They need to be separated by a few hours. Some supplements are best taken with food and if that’s the case, it will say so on the label. B vitamins will give you energy and alertness, so those are best taken in the morning or early afternoon. Certain nutrients compete for absorption, such as calcium and iron. So if you’re taking both in supplement form, you want to take them at separate times of the day. These are just a few examples of why it’s important to seek the help of a professional on the timing of your meds and supplements.
Q: How long should I continue taking my supplements?
A: Again, the answer really differs – depending on the type of supplement. A high quality multi-vitamin/mineral, for example, can usually be taken safely long-term, whereas with fat-soluble vitamins, such as vitamin D, higher doses should only be taken if blood levels are being monitored. Herbal supplements may be prescribed for acute illnesses, like colds and flus, which would be more of a short-term usage. I’d encourage anyone taking supplements to do the research on the individual ones they take (or are considering taking). Even for those that are safe to take daily, I think it’s a good idea to switch things up from time to time, like changing brands periodically or taking a few days off once in a while. (If you’re on a supplement protocol recommended by a healthcare professional, check with them first before changing your routine).
Q: Will I become dependent on taking supplements?
A: This risk of dependency is generally associated with certain prescription medications rather than dietary supplements. Nutrients and other kinds of supplements address deficiencies and support the body’s natural healing mechanisms, whereas drugs are often prescribed to suppress symptoms. When the root causes of health problems are not addressed and must be managed from now on with medications to keep symptoms at bay, the risk of dependency is much greater. However, in certain populations, research has shown that supplementing with high doses of antioxidants regularly may signal the body to stop producing them on their own (works like supply and demand). Talk with a professional if you are considering taking any supplements at a high dose or for an extended period.
Q: What professionals are qualified to recommend supplements?
A: If you’re looking for evidence-based information on supplements and personalized recommendations from experienced professionals, the most qualified individuals are licensed healthcare professionals with nutrition in their scope of practice–specifically those who have specific training or interest in integrative/functional medicine or herbal medicine. These may include medical doctors, chiropractors, naturopathic physicians, and acupuncturists. Nutrition professionals and herbalists with post-graduate degrees are also a great option (in some states there are restrictions on what types of nutrition professionals can dispense nutrition advice, so check your specific state laws).