Supplements: What To Look For

Today's dietary supplements make some mighty big promises: Stop aging! Lose weight without dieting! Burn fat in your sleep!

Unfortunately, it's hard to sort through the hype, particularly in a category that ranges from vitamins and minerals to herbs and specialty supplements. Normal healthy adults should be able to get all the nutrients they need from a good diet. Supplementing can be smart for certain individuals, such as pregnant women or the elderly. But while vitamins and minerals help maintain good health, their role is unclear when it comes to fighting disease.

Although studies have shown that people who eat plenty of fruits and vegetables have a lower risk of cancer, clinical trials using supplements such as beta-carotene have shown little, if any, reduction in risk. Herbal supplements are defined as dietary supplements, and escape the regulatory oversight given to food and drugs. There is no testing requirement for proof of safety and efficacy, no guarantee that what's listed on the label is in the product, and no assurance of quality control.

There are other safety concerns to consider with herbal and specialty supplements. Consumers often assume that "natural" products are safe, but that's just not the case. Any time you take a product, it's possible to have an allergic reaction.

Drug interactions are another important issue. Combining large doses of vitamin E, ginkgo, ginseng or garlic with medications that thin the blood -- like prescription warfarin or even aspirin -- could increase the risk for serious bleeding problems.

So what should you be aware of when you shop for supplements?

  1. LOOK FOR "USP" OR "NF." The U.S. Pharmacopoeia is an independent, nonprofit testing laboratory; compliance with their standards is voluntary. Vitamins and minerals with USP on the label meet the lab's standards for identity, purity, strength, disintegration and dissolution. Recently, the lab has begun developing National Formulary (NF) standards for herbs and botanicals. Products labeled NF have been used without significant safety risks.
  2. KNOW THE RIGHT DOSE. Herbs and botanicals don't always have a scientifically established dosage, and recommendations on labels can vary widely. Double-check the standard dose and potency with a reliable source.
  3. HEED LABEL WARNINGS. Even if the label covers potential side effects, ask your pharmacist about other possible reactions. Don't exceed a prudent dose, and always check with your doctor first if you're pregnant or breastfeeding, have a chronic health condition, anticipate surgery or take other medications.
  4. CHOOSE STANDARDIZED EXTRACTS. This is an imperfect science, but most manufacturers try to ensure potency by using a uniform percentage of the active ingredient in every pill.
  5. LEARN THE LABEL LINGO. Take the time to read the supplement labels carefully. Some companies claim to provide results that are neither accurate nor humanly possible. In the past, any product could claim to be "high-potency." Now, that term can be used only if the supplement supplies 100 percent or more of the RDA for that vitamin or mineral. If "antioxidant" is used, there must be evidence that the substance inhibits free radicals, potentially damaging by-products of the body's metabolism.
  6. TRY A MULTIVITAMIN. Overwhelmed by so many products? Perhaps the safest -- and easiest -- rule of thumb is to stick with a multivitamin/mineral supplement that has 100 percent of the RDA for most nutrients.
  7. SKIP COMBINATION HERBAL PRODUCTS. There's little research to support that combination products (for example, formulas that combine kava kava and valerian) work better than individual pills, and they may not contain enough of any substance to have an effect.
  8. GET THE MOST FROM EVERY DOSE. Most supplements should be taken with a full glass of water, and some are best absorbed if you take them before or after a meal (if the label doesn't say, check with your pharmacist). Don't bother with timed-release claims; there isn't enough research to support a benefit. Likewise, there's little evidence that chelation -- a process in which a mineral is bound to a protein -- improves absorption.
  9. LOOK FOR A LOT NUMBER. Responsible manufacturers include these numbers to assist in tracking and recall efforts in case of problems. And check the expiration date. Many supplements lose potency over time.
  10. JUST BECAUSE IT'S LABELED "NATURAL," "HERBAL," OR "NATURAL AND HERBAL" DOESN'T MEAN IT'S SAFE. Consider poisonous mushrooms. They're natural but they're still POISONOUS.

In addition, keep in mind that natural and synthetic vitamins are basically the same thing. If you think about it, nothing that comes in a pill form is "natural." Mother Nature created a bunch of crazy stuff, but she managed to stay away from tablet and gel cap production.

Basically, synthetic vitamins are just cheaper to make. A vitamin's price doesn't reflect its potency. Higher priced vitamins aren't any better than the bargain variety. Consider the name of the manufacturer or distributor. Supplements made by a nationally known food and drug manufacturer, for example, are more likely to have been made under tight controls because these companies already have set in place manufacturing standards for their other products.

It's fine to buy supplements containing sugar and starch. These are sometimes added to ensure better nutrient absorption. Store brands may be just as good as name brands. Bet you didn't know that both brands could even be made by the same manufacturer. Store brands are usually less expensive because you're not paying for advertising.