Supplements: the hard to swallow pill.

7 min readAug 25, 2021

Dietary supplements might not be as harmless as you thought.

Supplements can be important, even life-saving, for people with deficiencies or those who aren’t able to efficiently absorb nutrients from food. However, a lot of people take a supplement for anything and everything. It almost seems like there is a general belief that the more pills we take, the healthier we will be.

With the heated debate around COVID-19 vaccines happening right now, I really started to think about the hypocrisy of many individuals in the wellness space. People will recommend you to take multiple supplements daily, yet argue that a life-saving vaccine isn’t safe due to “lacking evidence”.

The truth? Supplements are much unsafer, if we consider evidence the measure. Why? because of federal regulations of drugs versus supplements.

Drugs are considered unsafe until proven safe, supplements are considered safe until proven unsafe.

The different approach to drugs and supplements is the biggest problem. If I wanted to, I could start selling a dietary supplement tomorrow and I wouldn’t have to prove it does anything, as long as I put a disclaimer on the label. No supplement on the US market has to undergo any testing to prove it is safe, or even effective.

This approach was established in 1994 with the Dietary Supplement Health and Education Act (DSHEA). The act defined dietary supplements as a category of food, which allowed the industry to avoid the rigorous testing drugs have to undergo before entering the market. The FDA (Food and Drug Administration) has the authority to stop a company from making a supplement, but only when the agency can show evidence that the product poses a significant risk to the health of the general population. This means that enough reports of people having severe adverse effects would need to be present before a manufacturer can be stopped from distributing their product. In reality, this happens very rarely.

Supplements are self-prescribed.

Most consumers don’t consult supplement intake with a healthcare professional, which means they aren’t aware of interaction, side effects, or dosage. There is also no system for reporting bad reactions and side

effects. In contrast, there is a controlled reporting system for drugs, so any side effects or interactions with other drugs, foods, or supplements will be spotted and addressed quickly.

What makes this worse, is that supplements can have adverse effects and they also do interact with drugs. Megadoses of some supplements, including zinc, vitamin C, or iron, might negatively impact health. Herbal supplements are of concern, as the substances in herbs are powerful. For example, black cohosh may reduce the effectiveness of statins, ginkgo increases the risk of bleeding in individuals taking blood thinners, and the FDA cautions against taking vitamin E and blood thinners together.

The bottom line is that combining dietary supplements and medications could have serious and even life-threatening effects but most consumers don’t consult with a health professional before taking a supplement. As a result, most will never know that a supplement caused any adverse reactions and other lifestyle factors, or even the medication itself, might be blamed.

Contaminated with heavy metals, pesticides and more…

Since DSHEA made it easier to sell supplements, the FDA and other independent researchers have completed some trials and the findings are truly concerning.

Past reports have repeatedly shown that many supplements contain none of the ingredients listed on the label or additional ingredients not listed. Supplements, including protein powders, can be contaminated with germs, pesticides, or toxic heavy metals… and nobody would know.

Even more concerning, some herbal supplements have been found to contain prescription drugs or other compounds that should not be taken without medical supervision. This includes substances such as Viagra or Cialis. Some weight loss supplements were found to contain Sibutramine, a substance that can significantly increase the risk of heart attack and stroke. Supplements marketed for joint pain, muscle pain, osteoporosis, or prostate health have been found to contain Diclofenac — a prescription non-steroidal, anti-inflammatory drug. Additionally, one study found that about 35.7% of supplements marketed for bone and joint health contained Dexamethasone, a corticosteroid used to treat inflammatory conditions. Dexamethasone can cause spikes in blood sugar and cause weight gain. What is worse, some of the supplements contained more than one prescription drug, a mixture that can have serious health complications. While it is important to note that these are rare findings but they still are significant and expose the extreme lack of regulation and oversight.

Although they’re not tested very often, and usually it’s curious researchers who find the mistakes, many supplements are not what they are supposed to be. While it is not always the extreme cases, it is still problematic because no routine inspections are required on supplements, unless enough reports of adverse effects are present. Therefore, the public will be taking a given supplement, not knowing that it may not be what it is labeled as.

Manufacturers set safety standards

This adds to the confusion because each supplement manufacturer has their own standard. This means that the “same” product from two different brands might be completely different when it comes to composition, strength, or bioavailability. One report found that vitamin D3 supplements have deviations in strength ranging from 9% to 146% of the concentration stated on the label. While small deviations in potency are expected, only a few supplements were within the acceptable range of deviation.

The FDA has a mechanism in place to monitor safety of supplements. However, the problem is that it is a voluntary reporting system and the number of adverse effects reported after supplement use is still not close enough to the numbers estimated by the American Association of Poison Control Centers. This might be partially due to the fact that many of the reports don’t meet the guidelines for serious adverse effects, therefore the FDA can’t intervene. The whole system relies heavily on consumer awareness, which is a big ask. Additionally, the FDA is usually not able to make a direct link between reported side effects and the supplement, as most consumers have no medical record of supplement usage.

How to buy supplements?

All of this might sound scary, and it is! But not all supplements are bad. It is also important to distinguish between actually needing supplements and popping them as if they were completely harmless. When you look at wellness websites it may seem as if there was a pill for anything and the more you take the better. But supplements should be taken carefully and after consulting with a health care professional (and probably not the one selling them).

Marketing

This is the key for me. If the supplement is aggressively marketed to change your life, it most likely won’t. If a supplement makes crazy promises, just avoid it. No pill, that doesn’t have sketchy ingredients, will make your metabolism faster, make your pain go away, or improve your mood.

Certification

There are two trustworthy groups in the US that inspect supplements. The United States Pharmacopeia NSF International Manufacturers submit their products for review on a voluntary basis. This means that not all supplements undergo the review, however the fact that a manufacturer is willing to have their product inspected by a third party organization, should give you peace of mind. Even better if it passes and gets the approval seal. With supplements approved by those two groups, you can rest assured that the ingredients are clean, no other substances than those on the label are present, and the potency is what it claims to be.

Composition

In most cases, you will likely need a single ingredient supplement. The less, the better. If you need a vitamin D, purchase a simple vitamin D, instead of a “bode builder” that’s full of other stuff. Some supplements are meant to be a multivitamin, and that’s okay because it’s their purpose. For example, if you want a prenatal supplement, you will but a multivitamin instead of purchasing each vitamin separately. In this case, just look for one that has been inspected and approved to be safe.

Do you actually need it?

Ask yourself why you are taking the supplement. In many cases, we don’t really need pills. You might need a supplement if you have been diagnosed with a deficiency through blood testing, if you have a serious malabsorption disease, or if you are taking a drug that is known to deplete certain nutrients. However, many fancy supplements that promise glowing skin, stron bones, or more energy are usually a huge waste of money and more of a health hazard than benefit.

Sources

Originally published at https://www.happeanutrition.com on August 25, 2021.