By David H. Rahm, M.D.
Q: With so many supplements available at drugs stores, health food stores, on the internet and through mail catalog, it’s really hard to know what products are high quality. What do I need to look for to find the best quality nutritional supplements?
Before I can answer how to find the best quality nutritional supplements, it’s a good idea to first provide a definition. Then, I’ll discuss how quality affects two areas – manufacturing and product formulation. Although we often use the term nutritional supplement, the FDA uses the term “dietary supplement”.
Just to clarify, the term “dietary” does not imply weight loss. The term refers to a broader dietary pattern where dietary supplements are intended to supplement the diet and contain a vitamin, mineral, herb, botanical, amino acid, Omega-3, probiotic or any combination of these or other dietary ingredients.
Clearly, how a nutritional supplement is manufactured will determine its quality. So, understanding the laws that affect the manufacture of dietary supplements will help you to better understand what goes into a quality product.
Current Good Manufacturing Practices (cGMPs)
In 2007, the FDA published long-awaited Current Good Manufacturing Practices or cGMPs for dietary supplements. As of June 2010 all dietary supplement manufacturers are subject to the current GMPs. These rules ensure that these products are processed, labeled and packaged consistently and meet quality standards. In short, these rules help ensure that consumers have access to high-quality nutritional supplements.
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Third Party Verification Programs
Prior to the FDA issuing current GMPs, a number of third party organizations started offering certification and verification programs to supplement ingredient and finished goods manufacturers.
These programs cover two areas: 1) facility certification where the third party inspects and approves the manufacturing plant and 2) product/ingredient testing to verify the product’s label through testing of the material inside.
Third party organizations include the United States Pharmacopeia (USP), Natural Products Association (NPA) NSF International and ConsumerLab.com.
Look for Companies with Facility Certification
Reputable companies typically have third party certification of their facilities. VitaMedica’s plants are certified by the NPA. The standard operating procedures we use at our facilities parallel those that are used in drug manufacturing. In addition, the FDA inspects our facilities on a regular basis to ensure that the standards for production are upheld and pass routine inspections.
USP Certification and Quality
You may recall seeing the USP mark which appears on a number of supplements labels like the Kirkland brand. Although this mark is synonymous with quality, it doesn’t mean that the products without the USP mark are inferior. Getting a facility USP certified can cause a significant amount of expense and some companies choose not to go this route.
Keep in mind, that only a small number of dietary supplements can bear the USP mark. That’s because the USP has set standards (or monographs) for a relatively small range of supplements. For this situation, individual ingredients that have USP certification are used in a product formulation. Because many of VitaMedica’s formulations are unique, we use this approach for our nutritional supplements.
Label Matches What’s Inside the Product
In addition to meeting other requirements, companies complying with current GMPs have standard operating procedures for verifying the integrity of their ingredients. For example, incoming raw material ingredients are quarantined until quality control approves the material. Ingredients are routinely tested for contamination from metals and checked for bacterial and mold count. Upon passing inspection, the raw material is inventoried and later used for producing a product. Rejected raw materials are destroyed or returned to the supplier.
Once you know that you’re buying a high quality supplement from a reputable manufacturer, the next quality question to ask is will the product work best for my needs?
Quality Product Formulation
A mark of a good quality nutritional supplement is the product formulation. If you’re looking for a supplement that supports a radiant complexion, then you’ll want to make sure that the product is formulated with this health goal in mind. You should look for nutrients that support the development of collagen & elastin, help protect the skin from free-radical damage and lubricate the skin.
This is where having some knowledge of nutrition is helpful. By reading our Well Blog articles you can slowly develop your knowledge base.
Importantly, our formulations are developed using Evidence Based Medicine (EBM). This is a systematic approach which allows the integration of the best available research evidence with clinical expertise and patient values. As the medical director at VitaMedica, I rely on EBM to determine the appropriate dosing and timing of nutrients to deliver a given benefit. Periodically, our products are reformulated to reflect the latest research regarding a particular nutrient.
High Quality Ingredients
It makes sense that the selection of high quality ingredients will result in a higher quality product. While you may be more familiar with determining the quality of a fruit or vegetable, below you’ll find some things to look for to determine the quality of a dietary supplement. Here I just cover what to look for in vitamin, mineral, Omega-3 and probiotic supplements. Obviously, this doesn’t cover every type of supplement (e.g., herbal or botanicals, protein) but covers some of the more commonly used supplements.
Branded Ingredients. Companies spend significant resources to research and develop ingredients that have superior properties and benefits. Examples include BASF’s Betatane® natural, mixed carotenoid blend and Integrity’s Cinnulin® cinnamon extract. Nutraceuticals formulated with branded ingredients are typically more costly but you’ll have more confidence that the product will work.
Natural Vitamins. To keep costs down, lower priced supplements are often formulated with synthetic vitamin E. Although more expensive, research has demonstrated that the natural form is more readily absorbed than the synthetic counterpart. How do you know if a supplement uses synthetic vitamin E? Just look at the label. If you see an “l” in the ingredient list as in “dl-alpha-tocopherol acetate” that means the source is synthetic vitamin E. If you see just a “d” as in “d-alpha-tocopherol” that means the source is natural vitamin E.
The vitamin A (beta carotene) source used in many lower priced supplements also tends to be a synthetic. Vitamin A Acetate, a synthetic source, is an example. Again, this ingredient is cheaper to use than a natural source like Betatene® which is more readily absorbed by the body.
Full Spectrum of Vitamin E and Carotenoid Families. In addition to using a natural source, well-designed formulations include a broader spectrum of vitamin E. Although we think of vitamin E as a singular nutrient, in fact, the vitamin is comprised of two families: tocopherols and tocotrienols. Within each of these families are four members – alpha, beta, gamma and delta- totaling eight members. In foods with high vitamin E content, all of the members tend to be present. The members have complementary roles. Some convert more readily to vitamin E whereas others function as potent antioxidants. By isolating just one member, a common practice with supplements, you’re not getting the full spectrum of benefits from the vitamin E family. The ideal women’s multivitamin incorporates the mixed, natural form of both tocopherols and tocotrienols, to confer the widest number of health benefits.
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For the same reason, instead of just using beta-carotene, well-designed formulations use a carotenoid blend which not only includes beta-carotene, but lutein, zeaxanthin, cryptoxanthin, lycopene. Each of these nutrients belongs to a family of compounds called carotenoids. Some carotenoids, like beta-carotene, convert readily to vitamin A or have pro-vitamin A activity. However, the vast majority of carotenoids, like lycopene, do not have any vitamin A activity. Instead, they exert powerful antioxidant benefits.
Chelated Minerals for Maximal Absorption. Minerals can be difficult for your body to absorb so formulas that contain chelated minerals are a great choice. Chelation is a technology that attaches an amino acid (protein) to a mineral. When ingested, the body absorbs the amino acid and, as a result, is “tricked” into absorbing the mineral.
Avoids Unnecessary Ingredients. We’re increasingly exposed to chemicals in our environment and food so taking measures to prevent these harmful compounds from entering our body is important. Read the label on nutritional supplements and avoid products that contain artificial dyes, colorants, shellac or wax (a coating agent which aids in swallowing of tablet). Examples: One a Day Woman’s contains FD&C Blue #2 Lake, FD&C Yellow #5 (tartrazine) Lake, and FD&C Yellow #6 Lake; Geritol Multivitmain contains FD&C Blue #2, FD&C Red #40, FD&C Yellow #6 and Carnauba Wax.
Quality Markers for Probiotics. The best probiotic supplement is one that meets your digestive or immune health needs. Having some basic knowledge of probiotics is helpful as a wide range of products and delivery forms are available. However, a good probiotic supplement is formulated with resilient strains, at sufficient levels (CFUs), includes a prebiotic and uses enteric coated capsules to ensure that the beneficial bacteria not only withstand the trip through the digestive tract but thrive once they reach their final destination.
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Organically Grown, Cold Pressed Seed Oils. The hallmark of a high-quality nutriment oil like flax, borage or pumpkin seed, starts with organically grown, non-GMO seeds. Next, the oil is carefully extracted from the seeds using an expeller pressing method at low temperatures without exposure to damaging light, oxygen and reactive metals. This ensures a premium quality product with exceptional taste. Carob coated softgels and opaque or dark packaging further protects the delicate oil from degradation during the product’s shelf-life. VitaMedica’s Organic Flax Seed Oil uses an exclusive omegaflo® fresh pressed process to protect our flax seed oil. Carob coated softgels, vitamin E and blue PETE bottles further protect the oil from oxidation.
USP Verified Fish Oil. The hallmark of a high-quality fish oil supplement is a product that is verified by the United States Pharmacopeia (USP). USP verification ensures that the fish oil supplement consistently provides accurate amounts of EPA and DHA as reported on the label and is free of contaminants like PCBs, dioxins and heavy metals. VitaMedica’s Super EPA/DHA Fish Oil is USP verified so you can trust the source.
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Lot Code and Expiration Dating. The FDA does not require that nutritional supplements have a lot number or date coding. However, good quality products will include this information. Each VitaMedica product includes a lot number and expiration date to ensure delivery of the nutrients as stated on the packaging. Our nutraceuticals have a 2 year shelf-life; our homeopathics have a 5 year shelf-life.
This represents a short list of things to look for when searching for high quality nutritional supplements. Obviously, the more you know about nutrition, the better you will be able to assess whether a dietary supplement will meet your health & wellness needs. Reading our weekly articles will go a long way toward developing your knowledge base.
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.