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Written by Chris Bellanger, BHSc in Nutritional Medicine
In an era where personal wellness and health optimization are prioritized, nutritional supplements have become a go-to for many seeking to boost overall well-being, improve athletic performance, or manage specific health concerns. Despite their popularity, the supplement market is vast and can be bewildering. This comprehensive guide is designed to help health-conscious consumers navigate the complexities of choosing high-quality nutritional supplements.
One of the first steps in choosing a good nutritional supplement is understanding how to read and interpret supplement labels to ensure you make an informed decision.
Unlike prescription medications, nutritional supplements in the USA are not regulated by the Food and Drug Administration (FDA) before they are marketed. This lack of regulation allows consumers the freedom to choose from a wide variety of products but also places the responsibility on individuals to do their research to ensure they are selecting safe and effective products.
It is well known in the industry that unethical companies frequently manufacture and distribute adulterated or mislabeled supplements. Some brands also use misleading or exaggerated health claims in their marketing literature and may omit to mention possible side effects.
Unfortunately, many supplement companies are not ensuring the quality of their products, with the FDA finding violations in more than half of the 656 production facilities inspected in 2017, the most common being a failure to establish final product purity, strength, or composition.
One study of 16 probiotic supplements found only one that perfectly matched its label ingredient claims, while another study analyzing 28 brands of red yeast supplements, which contains monacolin K, a compound identical to the cholesterol drug lovastatin, found that the quantity of the desired compound varied more than 60 fold, from 0mg to 5.48mg per 1.2 grams of red yeast rice. (1, 2, 5)
Another study by Consumer Reports found heavy metal contamination in 40% of the 133 protein powders, with the highest levels found in “mass gainer” protein types and the lowest in whey protein powder. (3)
Find out more about collagen peptide powder as we debunk the most popular myths.
The FDA and advocacy groups such as the Center for Science in the Public Interest have published numerous warnings about contaminated supplements from dubious brands and fraudulent companies.
The Tainted Supplement Database was created by the FDA in 2007 to identify and list dietary supplements adulterated with active pharmaceutical ingredients (APIs). A study looking at data compiled by the database found 1068 contaminated products, mostly in the weight loss and sexual health categories, and not uncommonly using banned drugs such as sibutramine. (4, 15)
This Dietary Supplement Label Database maintained by the National Institute of Health is useful for checking labels by product, brand, or ingredient.
The list of ingredients should identify the active components of the supplement. These are the substances intended to provide health benefits. For instance, if you are looking for a vitamin D supplement, the label should specify whether it contains Vitamin D2 or Vitamin D3, with D3 generally being more effective. (14)
If you are still weighing the facts on which supplements to take, a great evidence-based resource to research the effectiveness of nutritional supplements that's completely independent is Examine.com.
The label will indicate how much of the supplement constitutes one serving. This is important for ensuring you take the correct amount. For example, a supplement might suggest taking one tablet daily, but it’s essential to ensure this aligns with your dietary needs. Accurate dosage instructions are vital. Overdosing on certain supplements can lead to adverse effects, while underdosing may result in ineffectiveness.
Don’t neglect inactive ingredients! This includes fillers, binders, and stabilizers. While these ingredients may not impact the supplement’s effectiveness directly, they can be detrimental for those with allergies or sensitivities.
Some supplements contain artificial colors, flavors, or preservatives. These additives do not contribute to the supplement’s health benefits and may cause reactions in sensitive individuals. Opt for products with minimal additives or natural alternatives to ensure a pure product.
Supplements that have undergone third-party testing are generally more reliable. Organizations such as NSF International or USP (U.S. Pharmacopeia) test supplements for potency, purity, and contaminants, providing an additional layer of assurance.
Understanding potential side effects helps you assess whether the supplement is suitable for you. Common side effects should be listed on the label or available through the manufacturer’s website.
Aside from known interactions of label ingredients, there is significant risk from ingredients not listed on the label, as is increasingly common due to unscrupulous players in the industry. Impurities, contaminants, or adulterants are not uncommonly found in nutritional supplements.
Some herbal products have been associated with severe adverse effects, such as liver damage, and heart problems, which it seems most likely were from contaminated products containing unlisted ingredients, so it is extremely important to check your brands (6, 7, 13, 15)
Be aware of possible interactions with other medications or supplements you are taking. Medline offers one of many great drug, herb, and supplement interaction databases.
If you follow a specific diet, such as veganism or gluten-free, ensure the supplement aligns with your dietary needs. Check for certifications or statements indicating the absence of animal-derived ingredients or gluten.
Proper storage can impact the supplement’s effectiveness. Follow the storage instructions on the label, such as keeping the product in a cool, dry place, to maintain its potency and prevent degradation.
Although the FDA does not pre-approve supplements, it does monitor the market for unsafe products. Avoid supplements flagged or recalled by the FDA, and stay informed about any warnings.
Check here to see if the brand received any FDA warning letters.
Several key factors can help you identify high-quality supplements amidst the plethora of options available, including ingredient quality. Look for supplements with standardized extracts, which ensure consistency in the concentration of active ingredients. For instance, a standardized extract of ginseng will have a guaranteed amount of ginsenosides, the active components.
The form of the nutrient affects its effectiveness. For example, Vitamin D3 is generally preferred over Vitamin D2 because it is more effectively utilized by the body.
Choose supplements that are free from unnecessary additives, fillers, and artificial ingredients. Products that are tested for purity by third-party organizations are often preferable. Some unwanted adulterants may be listed as “fillers” or additives.”
Bioavailability is another crucial factor regarding how well the body can absorb and use nutrients. For instance, certain forms of magnesium, like magnesium citrate, are more easily absorbed than others, such as magnesium oxide. (14)
Good Manufacturing Practices (GMP)ensure the supplement is manufactured in a facility that ensures products are consistently produced and controlled according to quality standards. Check the product's country of origin, as certain countries, such as Australia, have much stricter regulations on supplements and thus better quality, while other countries have lower standards and oversight.
Reputable brands should also be transparent about their sourcing, manufacturing processes, and testing procedures. This transparency reflects their commitment to quality and consumer safety.
If you have known allergies or sensitivities, select supplements that are free from common allergens such as gluten, dairy, soy, and nuts. Many manufacturers offer allergen-free options.
High-quality supplements are often packaged in dark or opaque containers to protect against light, moisture, and air, which can degrade the product’s potency.
While price is a factor, it should not be the sole consideration. Higher-priced supplements may offer better quality and effectiveness but ensure that the product’s quality justifies the cost.
The FDA requires manufacturers to list all ingredients on the product facts panel, along with the quantity by weight, except when the product is covered by a “proprietary blend”, which allows the manufacturer to avoid listing the quantities of each ingredient.
This is supposed to help encourage innovation and protect trade secrets, with some arguing that they may be based on years of clinical research or coming from traditional herbal medicine lore and should, therefore, be protected like intellectual property.
Congress enabled companies to use proprietary formulas to protect this information and keep it confidential from the public. However, while the label is legally required to list ingredients in descending order of the amount contained, and the FDA can request the exact formulation, in reality, this rarely occurs, and as we have shown with other products, dishonesty in labeling is increasingly frequent.
I recommend avoiding all products with proprietary blends, as more often than not, it seems that it's simply an excuse to avoid listing large amounts of cheap ingredients like taurine or glycine in an amino acid supplement while keeping the protein levels high on the label, for example.
Many pre-workout products will use a proprietary formula, preventing them from disclosing the amount of each stimulant used. Active ingredients can be shown on the label, while in reality, there may be negligible amounts, rendering the product possibly worthless.
Thus, you cannot ensure the product contains effective amounts of the key ingredients you desire or check the safety of the formulation for your specific needs with your health specialist. (8)
Herbal supplements are often perceived as natural and, therefore, safe. However, this perception can be misleading due to potential issues with regulation and quality control. (9)
One review of over 200 herbal products from 37 countries revealed 27% with adulteration. Supplements, as well as pharmaceutical supply chains, can involve multiple suppliers and manufacturers, both international and domestic, thus confusing the tracking of ingredient sources and quality. (10)
Better quality brands will employ regular batch testing of the raw materials and finished products to ensure quality, authenticity,and consistency in their products, and this will typically be stated on their website.
More recent improvements in supply chain management include blockchain digital ledgers that ensure supply chain transparency, supplier verification, ensuring growers follow good agricultural and collection practices, as well as implementing traceability systems that track ingredients from source to finished product.
In addition to the certifications mentioned earlier, organic and fair trade certifications can offer an extra layer of quality and authenticity standards while also reducing the temptation of growers to adulterate their products for profit.
The most prominent issues concerning herbal supplements include:
Adulterants can range from cheaper botanical substitutes to synthetic chemicals and may include cheaper or misidentified plant species (sometimes toxic), pharmaceutical drugs such as sildenafil or corticosteroids, artificial colors or flavors, fillers such as chalk or talcum powder, binders like starch or dextrin, caffeine, and even sawdust, wheat or rice flour. (11)
Poor growing, production, or storage practices can lead to heavy metal contamination, pesticide residues, and/or mold and mycotoxins. (13) Essential oils are commonly adulterated with synthetic fragrances or cheap carrier oils.
Detecting adulteration can be challenging, but several strategies can help consumers and manufacturers identify compromised products:
The supplement industry is rife with marketing hype, often driven by trends which may not be scientific. To avoid being swayed by unsubstantiated claims, it’s crucial to differentiate between marketing and evidence-based information.
You can use Examine.com alongside other reputable and independent resources to check the research. Also, be wary of supplements that make bold, sweeping claims such as “miracle cure” or “guaranteed results.” These statements are often not supported by scientific evidence and can be misleading.
While celebrity endorsements can bring attention to a product, they do not necessarily indicate quality or efficacy. Always base your decision on scientific data, not popularity.
When evaluating scientific research, you want to:
Consumers should be vigilant, selecting high-quality products from reputable sources with a strong reputation and looking for certifications that indicate thorough testing from manufacturers and retailers who adopt stringent quality control measures to prevent adulteration, including regular testing and adherence to good manufacturing practices. (11)
Adulteration of nutritional supplements not only reduces the therapeutic effect but can also pose significant health risks such as organ or neurological damage, allergic reactions, drug interactions, carcinogenic effects, or reproductive and developmental toxicity.
With due diligence and informed choices, you can navigate the supplement market safely, ensuring that the products you choose are both effective and beneficial for your health.
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