There are numerous companies that are presently manufacturing supplements in North America. These supplements can be obtained at health food stores, online, and at doctors offices. I believe its important for consumers to know that some of these companies have impeccable quality assurance and manufacturing standards, and some follow literally no quality assurance protocols and create products that may either be useless or even potentially harmful.
Some supplement manufacturers routinely, and illegally, sell their products without first having to demonstrate that they are safe and effective. Presently, quality assurance testing is only optional on the part of supplement companies. You may be wondering what FDA (Food and Drug Administration) is doing regarding this subject? As of now, FDA has not yet made full use of even the meager authority granted it by the industry-friendly 1994 Dietary Supplement Health and Education Act (DSHEA). Therefore, my advice to you is to always do a background check (which is not easy to do) on the manufacturer before you purchase their products. The higher-end supplement companies do NOT sell to over-the-counter venues, and only sell to doctors clinics. To my knowledge, doctors offices, by and large, only carry supplements from these higher-end companies which gladly share their quality assurance paperwork for each and every product. Note that such companies can carry such prestigious certifications as ISO 9001 which is by far the worlds most established quality framework, currently being used by over 1 million organizations in 170 countries worldwide, and sets the standard not only for quality management systems, but management systems in general.
Although I have seen many cases where lower-end over-the-counter supplements were not helpful for my patients, I have not seen many cases that, to my knowledge, patients were actually being seriously hurt by over-the-counter supplements. What prompted me to write this blog, however, is the following story:
Recently when a patient of mine came to see me, she reported how much better she had been feeling after she stopped taking two over-the-counter supplements that she had been using for quite some time. It turned out she was taking Nature Mades calcium and magnesium supplements. Apparently, taking these supplements was interfering with her sleep which she desperately needed since she suffers from depression and poor memory. Both of these conditions are typically seriously impacted by sleep deprivation. Typically, calcium and magnesium are helpful for insomnia. However, these particular over-the-counter supplements were worsening this patients insomnia. Upon further examination of the supplement bottles, I noticed a long list of potentially harmful chemicals (as opposed to healthy nutrients) that the manufacturer had so boldly admitted putting into these supplements. The list of ingredients in Nature Mades calcium supplement bottle is as follows:
Calcium Carbonate, Maltodextrin, Hydroxypropyl Methylcellulose, Croscarmellose Sodium, Acacia, Titanium dioxide (artificial color), Magnesium Stearate, Silicon Dioxide, Polyethylene Glycol, Triehtyl Citrate, Polysorbate 80, Sodium Citrate, Corn Starch, Phylloquinone, Vitamin D3. Note that in addition to calcium and vitamin D, which are supposed to be the main ingredients, the remainder of the ingredients are mostly chemicals that are, at the best, somewhat questionable, if not frankly toxic. Some of these chemicals are artificial colors and some are fillers.
Another example of an over-the-counter supplement that I have never, in my practice of 8 years, seen to be effective is Glucosamine Sulfate from Costco. (Note: Glucosamine Sulfate is a wonderful supplement that is commonly used for the treatment of osteoarthritis pain, which is caused by wear and tear of cartilage in joints.) I have had numerous patients who took Costco Glucosamine Sulfate without experiencing any relief from their osteoarthritis pain. Almost all of these same patients found significant relief within weeks of taking Glucosamine Sulfate from higher-end companies.
According to Consumer Reports, there are numerous supplement ingredients that should be avoided because of health risks, including cardiovascular, liver, and kidney problems. Not all these ingredients are known toxins (such as heavy metals and pesticides), some may actually be safe ingredients (such as nutrients including selenium or chromium), but the amount may be off the chart, rendering the supplement toxic. Consumer Reports claims that because of inadequate quality control and inspection, supplements contaminated with heavy metals, pesticides, or prescription drugs have been sold to unsuspecting consumers. Note that the FDA rules covering manufacturing quality don’t apply to the companies that supply herbs, vitamins, and other raw ingredients. Additionally, China, which has repeatedly been caught exporting contaminated products, is a major supplier of raw supplement ingredients. And, the FDA has yet to inspect a single factory there.
Due to numerous complaints by consumers regarding a particular over-the-counter supplement a couple of years ago, the FDA tested the contents of the products at the manufacturers facilities. Most of the samples contained more than 200 times the labeled amount of selenium and up to 17 times the recommended intake of chromium. Even healthy ingredients, if taken in unhealthy amounts can cause severe health problems.
As can be seen, its critical to use supplements that are guaranteed to have high quality. There are numerous such companies in North America. Douglas Laboratories, for example, which manufactures a doctors line of supplements as opposed to an over-the-counter line, offers uncompromising operational practices at their facilities which include the following:
-cGMPs (current Good Manufacturing Practices) for nutritional supplements in accordance with USP (United States Pharmacopeia)
-NSF International has GMP Registered Douglas Laboratories manufacturing facility
-ISO 9001 certification of in-house laboratories performing Chemical, Physical, and Microbial testing
-ISO 17025 accreditation of in-house laboratories
-Veri-Match electronic label match to formula system to ensure content accuracy
-VCP (Vendor Certification Program) to ensure raw material quality
-FDA Audit Compliant
-Approved facility to product Organic Certified Products
-Approved facility to produce NSF Sport Certified products
-Member of Council For Responsible Nutrition
At Whole Health Clinic, we carry only doctors lines of supplements made by the purest supplement companies in North America and Europe. All of these companies offer various quality assurance certificates on their products. The following is a non-exhaustive list of supplement companies at our dispensary: Thorne, Seroyal (Genestra and UNDA), Standard Process, Douglas Laboratories, Biogenesis, Integrative Therapeutics, Hahnemann laboratories, and Priority One.
Last, but not least, it is noteworthy that certain natural medicines are by prescription only. These include such pharmaceutical items as natural thyroid hormone (also known as Armour thyroid), and female bio-identical hormones (such Estrodiol and Progesterone). There are other natural medicines that are by prescription only, but are not pharmaceutical, and thus not available over-the counter or at drug stores, and are only available at your licensed alternative medicine health care practitioners office. These include high potency homeopathic remedies (in 200C, 1M, 10M, or higher potencies), and potentially even gemmotherapies, oligotherapies, organotherapies, etc.
Whether you can obtain any of your medicines or supplements over-the-counter or not, its always advisable to discuss your health concerns and choice of supplements/medicines with your health care provider. For instance, you may have read that Vitamin B3 (niacin) can help lower your cholesterol, which is true. However, you may not know that niacin can cause hot flashes. If you happen to be a menopausal woman with high cholesterol, who is suffering from hot flashes as well, you may not realize that niacin, although it may be helping lower your cholesterol, may be worsening your menopausal symptoms. Therefore, what appears to be a safe nutritional supplement (even if it is high quality), may be worsening your overall health. Thus, the need to consult with your naturopathic physician as to what supplements you would benefit from taking or should actually be avoiding.
In health,
Dr. Sharif