I promise I’m going to give you a practical list on how to pick a supplement, but it probably won’t be a list you are expecting. First, I want to share an anecdote with you on what it’s like to receive a random supplement in the mail.
Sometimes companies send me things in the mail to review. Usually the products are related to wellness. Recently I’ve received CBD-infused soda, a magnetic shield designed to stick to your phone and “block out EMF radiation” and a bottle of green capsules that supposedly make one breathe better. I didn’t drink the CBD-infused soda. I gave it to my neighbor, because he wanted it, but only on the condition that he acknowledge that I could not vouch for the soda’s contents nor was I responsible for any side effects. I figured the shield didn’t work, but I wanted to read the accompanying insert on why the company says it works, because usually they are deliberately impossible-to-understand explanations that use an obnoxious amount of big, scientific words. I am interested in the health effects of EMF non-ionizing radiation, but from everything I’ve read, and from conducting an interview with Dr. Paul Heroux, a doctor who actually researchers the evidence for commercial EMF shields, I learned that if these tiny, EMF shields doanything, it’s make our exposure worse
The breathing supplement was in a league of its own. It came with no literature, no company information…, just a bottle of green pills. I initially responded to the company via email that I would review the product, but once I received it and realized I couldn’t possibly review it since there was no accompanying information or logic behind the included ingredients, I canceled the review. There was nothing substantial on their website either, just a few positive reviews. Of course, I had no idea if the reviews were fake or not. Having consulted with several health companies, whether it be for business, medical writing or data analysis, I know a lot of positive reviews can be fake. I held the bottle in my hand and chuckled. I felt like Alice in Wonderland, when she falls down the rabbit hole and is presented with enticing pastries that say, “Eat me.” The bottle might as well have said, “Try Me.” I will give the breathing supplement one thing: It only had one health claim. Usually companies tell me their supplements help at least ten health issues.
Unfortunately, supplements have become synonymous with wellness, and they are a big reason for why wellness is a 4.2 trillion dollar business. People buy them, and whether they are backed by evidence or not, folks are convinced they work. That’s the magic of marketing working in synergy with our positive expectations. But, given that supplements can be an extremely lucrative business, do you think everyone in the game is putting your health before their profit? No. No, not everyone is.
Though thousands and thousands of commercial supplements are sold each year, the field is highly unregulated, so it’s difficult for a consumer to know who to trust and what to take. In that sense, the wellness industry is a lot like the wild west, which is why I often refer to the industry as Wild Wellness. As I describe in my comedic parody, Yours in Wellness, Krystal Heeling, anyone can make a supplement, market it and sell it. Anyone. No one has to be verified, nothing has to be tested and randomized controlled trials, the gold standard of evidence, are not required. Researchers and investigators have shown that many supplement companies aren’t honest. In 2015, the New York State Attorney General ordered four large retailers to stop selling many herbal supplements that were shown to not contain the ingredients listed on the labels. I’ve featured severaly primary researchers of supplements on my Causes or Cures podcast. Dr. Ryzmski discussed potential contaminants in the popular microalgal supplements, Spirulina and Chlorella, often called “superfoods” by wellness enthusiasts. Some contaminants were even neurotoxins, which, I can assure you, are not super. He also mentioned that contaminants in supplements can be teratogenic, meaning they can harm a developing fetus. Dr. Ramasamy discussed the overall ineffectiveness of the most popular commercial supplements for male infertility and sexual dysfunction, and his research was based on the generous assumption that labels were accurate. I also did an interview with Dr. Bill Gurley, the principal scientist at the National Center for Natural Product Research at the University of Mississippi, about the many commercial CBD products that are inaccurately labeled and, worse yet, contain dangerous synthetic compounds. If you listen to his podcast, he also provides tips on how to pick a supplement and even name drops some trustworthy companies.
Before I list practical tips on how to pick a supplement, I want you to know that I’m not giving drug companies a pass. While the FDA regulates prescription drugs, we all know the system has its issues. Many prescription drugs have side effects, some that consumers are informed about, but others they are not. There is a very active online community, the “Prescribed Harm” community, that is filled with people who experienced serious side effects from prescribed medication and are now advocating for a more thorough process of informed consent. Drug companies have been sued for not reporting or downplaying side effects, as well as encouraging off-label prescribing. To save money, drug companies look to other countries for active pharmaceutical ingredients, or the substances in drugs that are biologically active. An FDA report shows that 72% of APIs are manufactured outside of the US, in places where the FDA has no power. Popular drugs, like Zantac for heartburn, had to be recalled, because it was discovered that they contain a cancer-causing chemical, NMDA. My mom took it for a while and is afraid now. Valsartan, a popular blood pressure medication, also had to be recalled for containing NMDA. Where were the active ingredients for these drugs made? Not in the US. Until this issue is appropriately addressed, how comfortable should people feel when they read that a drug is “FDA-Approved?”
Anyhow, we need to make improvements all around, and we need to make them fast.
What if someone is set on taking a supplement? What should he or she do? This isn’t a perfect list, but here is what I do…and what I recommend for how to pick a supplement:
- Make sure you’re sure. Be sure you need the supplement. Are you actually “low” in something, or do you just think you’re low? Be honest about your assessment. Most people take a supplement because they “assume” they are low in something. My recommendation is to get a measurement if you can. For example, do a blood/urine test for whatever it is you think you’re low in.
- Before you take a supplement, ask yourself if you can get what you think/know you are missing in your diet? Can you add local, organically-grown foods to your diet instead of taking a supplement, and if so, why not try that route first? For example, when I’m premenstrual, I bloat, get cranky, have a tendency to snap at people and think less rationally than I normally do. I read studies that boosting Calcium and Magnesium during that time can significantly help with symptoms. I don’t know if I’m “low” in anything, but I add more calcium and magnesium-containing foods during that time. Do I “know” it’s helping? No. But it’s not hurting and the potential benefits, in this case, outweigh the risks.
- Once you decide on a supplement, make sure that it doesn’t interact with any other medication or supplements that you take. If you’re pregnant, make sure it’s safe during pregnancy. If you get a chance to ask your doctor, run it by her/him, but beware: Most traditional doctors know very little about supplements. Therefore, some will almost instinctively advise against them, and others will tell you it’s safe because they assume the supplement is more of a placebo, doesn’t do anything or can’t cause significant harm. While that may be true for “some” supplements, some are bound to be physiologically active and affect you. For example, they may affect your heart, kidney or liver function. Also, supplements aren’t uniformly regulated and may contain contaminants. Be mindful of that, especially if you take a supplement and experience side effects.
- In general, most supplements won’t be supported by randomized controlled trials, but it’s still wise to check for any, as well as any published studies. When people pitch me a supplement, they send me a lot of background information supporting the “theory” behind a supplement, but rarely is there a well-powered study testing the actual supplement against a placebo. Keep in mind that supplement manufacturers often make many health claims per supplement. To address this, I would do a literature search ( for example, Google Scholar or Pubmed), to see if a supplement has been studied for any of the health claims. Though not considered a supplement, CBD products have been advertised for anxiety, sleep, depression, pain and more. Published studies are lacking in those areas, however studies have shown CBD to be useful in treating seizures in kids. Apple Cider Vinegar, another “superfood”, has been marketed for myriad health issues. Most claims are not supported with published studies. However, studies have shown it may help reduce the glycemic response after eating meals that rank high on the glycemic index. Also, just because a supplement isn’t supported by a published study doesn’t mean it doesn’t work, but it’s always wise to search for evidence. Studies can also help highlight any adverse effects created by the supplement. Unfortunately, it’s very expensive to conduct trials, which is probably the biggest reason that many aren’t studied in a controlled manner.
- Just because a supplement contains multiple ingredients that are shown to work for specific health issues doesn’t mean the ingredients work in synergy with each other.
- Know the difference between marketing and actual evidence. In other words, don’t fall for the bells and whistles. If you have questions, ask a health expert you trust who is unrelated to the company.
- Know the difference between a salesperson, a self-proclaimed expert, and an actual expert. What to look for? Experience, motives, credentials and honest communiation.
- When deciding on taking a specific supplement from a company, do your homework. Find out where the supplement is sourced. And when you find that out, double and triple check, because sometime it can be tricky. Go to the company website and learn where the company is based, if there is a contact number, if there is a “face” to the company, and how long the company has existed. Sometimes international sellers create fake company websites that make it look like the company is based in the US. Google “side effects from (insert Supplement here)” and see if anything shows up. Sometimes you’ll see something in a forum or on social media.
- Reviews are good, but don’t trust them. It’s very easy to create fake reviews online.
- Be careful of the “verified by a third-party lab” claim. It looks good, but not all labs are equal, some are only in it for the money, and it may not actually mean anything.
- Dr. Gurley, the principle scientist at the National Center for Natural Product Research, said ConsumerLabs.com is a reliable supplement review site. He is not affiliated with them in anyway, so this isn’t a biased recommendation.
- If you start a supplement, keep track of how you’re feeling. If you notice any negative side effects, stop taking it and report your symptoms.
This is a simple guide, but hopefully you’ll find it useful for how to pick a supplement. A lot of people ask me what supplements I take or what “brand” I use. I don’t take supplements at the moment. That might change in the future, but right now, I feel good and get what I need from my diet.
Thanks for reading, guys. Don’t forget to check out my comedic parody on the business side of the wellness industry, Yours in Wellness, Krystal Heeling. It’s now available as a kindle e-book and an audiobook. It’s short but drives home a lot of points about what’s wrong with the wellness industry. There is A LOT of good in the wellness movement, too, so please don’t get me wrong! I’m just using humor to point out some of the more suspicious stuff and provide stuff for folks to think about in terms of how to improve the wellness industry. I’m grateful for those of you who read it and reviewed it. It’s an independent effort and means a lot.
If you’d like to follow me on Instagram, where I regularly post health tidbits, here I am!
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