May 2024
THE REAL DEAL ON SUPPLEMENTS
You don’t need a prescription for the vitamins, minerals, and nutrient formulas that line drugstore shelves, but shopping with knowledge will help you make the best choices.
If a supplement is part of your daily routine, you’re in good company. In the U.S. 75% of adults take vitamins, minerals, and other nutrients in pill form. These products can be a good backup if you suspect you may not be getting all the nutrients you need in your diet, but there are many things to consider when choosing what to take. For one thing, depending on the source, you may not be getting what you think because there is often little oversight over what is produced and sold. Unlike prescription or over the counter drugs, the FDA doesn’t review or evaluate dietary supplements before they’re put on the market. Here are other important details you should know about selecting and taking supplements.
Multivitamins may contain different nutrients in varying amounts. That’s because there is no single formula that defines what can be called “multi.” Be sure to read the labels so you know how much of any single ingredient you’re getting. Also know the daily recommended intake for vitamins and minerals. It’s best to take the optimal amount of the nutrients you need and avoid overdosing with redundant ingredients across multiple supplements. Have a conversation with your healthcare provider first to pinpoint what vitamins, minerals, or nutrients you may need. For example, you may only require additional vitamin D, so you could simply take that instead of a multi.
The word natural doesn’t make the supplement better. Ideally, you will get the nutrients you need from your diet, as your body typically absorbs them best in their naturally occurring form. But because there is no official standard to meet for claiming a supplement is natural, that label doesn’t mean very much. For vitamins and minerals that are difficult to get via food, synthetic nutrients are often just as good as plant-based. This is especially relevant to vitamin B12, which is bound to protein in food and must be released from the food (made bio-available) before it’s absorbed. Also, B12 is very difficult, if not impossible, to get from plant-based foods. In some cases (like folate), research shows that the synthetic version is actually more easily absorbed by your body.
Supplements can cause negative side-effects or adverse reactions. Most commonly are various forms of digestive distress (such as nausea, diarrhea, and abdominal pain), headache and/or a bad taste in your mouth. One way to mitigate this is to take a supplement with food.
Certain supplements can have problematic interactions with medications. A few examples: Taking vitamin E supplements or fish oil capsules along with blood-thinning medications (such as warfarin or even aspirin) could cause the blood to become too thin, leading to easy bleeding and bruising. The same is true of vitamin K, but K can counteract the effects of blood-thinning medications. Taking iron supplements while on antibiotics (specifically those from the tetracycline class) can decrease absorption of the medication. Experts strongly recommend that you speak to your doctor about supplements that you’re considering taking and all the medications you’re on since the supplement could change absorption, metabolism, effectiveness, and potential side effects of certain medications.
A proprietary blend is basically a secret in a bottle. With the “proprietary blend” designation, if it’s their trade secret, manufacturers aren’t required to list all the specific amounts, or ratios or ingredients included in the formula. Instead, the ingredients are listed in descending order according to their predominance by weight in the formula. This means that it’s a guessing game as to how much of a component is in the formula.
Be cautious about health claims on supplements. Take a pill and relieve stress, boost energy, or improve your focus? Sounds easy, but there are no requirements for an over-the-counter dietary supplement to meet to make a benefit claim. Carefully read the ingredient list and discuss the list with a knowledgeable expert, such as a physician or registered dietitian. Many of the energy types of supplements contain caffeine or stimulant herbs that have the potential for side effects such as a racing heart or anxiety. There are also supplements that say they’re formulated to meet the needs of certain groups, such as older adults or women. Before taking one of these supplements, be sure to ask your doctor about what specific nutrients you may need.
More isn’t necessarily better. Excessive amounts of some water-soluble vitamins (including many B vitamins and C) are usually lost in the urine, but they can be toxic at extreme doses. Taking too much fat-soluble vitamins (A, D, E, K) can be especially problematic because these vitamins are stored in the body and can cause organ failure. A few examples: Too much vitamin A can be toxic to the liver and cause vision problems and swelling in the brain. On the mineral front, too much supplemental calcium can increase the risk of kidney stones, calcifications in your arteries and possibly heart attacks. And excess iron can be toxic, leading to liver damage, heart dysfunction, seizures, or other life-threatening complications. Also, taking too much of one nutrient could impact absorption of another.
How you store supplements matters. Proper storage of all types of supplements is essential. Keep them away from extreme heat, light, and open air to preserve their shelf life. Note that some supplements may be good for a longer period than others. For example, gummies tend to lose their potency and degrade faster because they are particularly sensitive to heat, light and moisture. Liquid supplements may also have a shorter shelf life and often need to be refrigerated to preserve their potency. One exception: Liquid oils like omega-3 supplements are quite stable. And you can keep them cold. Some people do better with the fishy aftertaste if the capsules are frozen. Whatever formula you choose, pay attention to the expiration date, and don’t use supplements beyond that date.
Supplement Smart
**Pay close attention to the amounts of vitamins and minerals in supplements and fortified foods. If you take both, you could be getting too much of certain nutrients.
Stacey Colino