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Choosing the Right Supplements

Last year U.S. consumers spent billions of dollars on vitamins and supplements.  Clearly, this is big business.  I believe that good health starts with food first - in other words, vitamins and supplements can not substitute for a good diet.  That being said, there are situations, especially with children who are picky eaters, where supplements can begin to replenish nutrients while the diet is being worked on.  Also, even a child who is not a picky eater may have some nutrient deficiencies if he or she is eating a standard American diet including processed food and refined carbohydrates.

So, with all of the hundreds of supplements, how do you know which one to pick?  First of all you need to make sure that the supplement is produced at a GMP facility.  GMP stands for "good manufacturing practice" and consists of standards set by the FDA to ensure safety and quality in manufacturing processes as well as ensuring that the actual contents of the supplement match those that are listed on the label without inaccurate ingredient concentrations.  The FDA periodically inspects facilities for GMP compliance, but does not specifically offer a certification. In addition, the FDA is understaffed in the area of monitoring supplement companies. You can find quality information on the websites of different companies saying whether their products are produced at GMP compliant facilities.  Some companies have GMP compliance listed on the product, but many do not.  Some large vitamin companies have their own manufacturing facilities, while smaller companies often contract with different manufacturers for different products.


There are several independent bodies that verify GMP compliance.  Two of these bodies are NSF (National Sanitation Foundation) and NPA (Natural Products Association).  These bodies verify that the supplement manufacturers are following the standards set by the FDA, including in house quality testing for contamination and inaccurate ingredient concentrations. The NSF seal is usually listed on the website or printed material from the company. The NSF seal is only allowed to be displayed on the actual products if the products are being tested independently by the NSF.  Most of the supplement companies do not have their products independently tested by the NSF - they just have their manufacturing processes independently verified.  The NPA operates in a similar manner as the NSF.  However, they do allow their NPA GMP certification seal to be displayed by suppliers who meet their standards.


A third independent body that verifies GMP compliance for dietary supplements is the USP standing for United States Pharmacopeial Convention, and their website lists companies participating in the USP verified program.  Dietary supplements from these companies also have the USP verified mark.


A fourth independent body is Consumer Labs.  In this case, the actual products off the shelf are analyzed, not the manufacturing process.  Product evaluations are listed on their web site for consumers who purchase a yearly subscription.


Some of the supplements found at the health food stores or online are manufactured in Canada. This is a good thing for consumers because Canada holds supplement manufacturers to the same standards as pharmaceutical drug manufacturers in terms of quality standards.


The second thing to look for in vitamins and supplements is to check the label for extra unwanted ingredients such as additives, fillers, colors, or allergens.  For example, the less expensive supplements need to use magnesium stearate in order to help in the mass production by machinery of a supplement.  The more expensive supplements do not use machinery in the same way and can leave out magnesium stearate.  There is controversy about whether magnesium stearate interferes with the absorption of the supplement.  In addition. some patients are sensitive to artificial colors or fillers which may be added to the supplement.


The third thing to look for particularly in vitamins is what form the vitamin is in and how bioactive it is.  Basically, you want to absorb and utilize as much of the vitamin as you can.  This gets to be a bit tricky because it may depend on your genetics and your general state of health as to what you absorb and how you utilize nutrients.  You may need help from an alternative health care provider to figure some of this out.  Some things to look for are: minerals are best absorbed when they are in the form of amino acid chelates. B vitamins are more bioactive in the form of 5-methyltetrahydrofolate for folic acid,methylcobalamine for B12, and pyridoxal-5-phosphate for B6.  Vitamin A should be at least partially in the form of B- carotene.


So, to summarize, look for supplements and vitamins that come from GMP compliant facilities, are free of artificial ingredients and fillers, and are at least partially bioactive.

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