6 Tips for Choosing Safer Dietary Supplements
If the sheer number of midlife women in the Whole Foods supplement aisle is any indication, many midlife women are loading up on supplements for things like gut health, joint pain, and brain health. While some research suggests that certain supplements may be beneficial in alleviating menopause symptoms for some women, the evidence is mixed. Many of the herbal remedies require further studies to support their efficacy and safety. Also, researchers express concern that when used in combination with other medications, some herbal products targeting menopause symptoms could pose serious health risks.
Whether you take supplements or not, many women have questions about the growing number of supplement brands, wildly different price points, best uses, and formulations. But an equally important question is: which supplements are safe?
Many dietary supplement companies may far exceed federal requirements for quality and safety in their products. Nonetheless, it’s important to understand safety risks involved with using dietary supplements and be knowledgeable of the best ways to avoid them — because the fact is, not every product is harmless just because it’s on the shelf.
So, how do you protect yourself? Here are 6 tips for making the best choices when it comes to dietary supplements.
1. Don’t assume that more is always better.
Just as higher cost doesn’t always equal a better product, taking high doses of extra vitamins and minerals doesn’t always equate to better nutritional “insurance”.
Healthful diets can be planned well enough to cover pretty much all the bases, especially with so many fortified foods available. This often makes a daily multivitamin overkill in attempt to meet nutritional needs for the average person.
Therefore, it’s important to identify any specific areas of potential imbalance in your diet, so that these nutrients can be targeted. This can be done with the assistance of your healthcare team, including a registered dietitian, and it may be beneficial to have blood work evaluated for deficiencies. Certain nutrients can be especially important during menopause, like calcium and vitamin D.
2. Understand how dietary supplements are regulated.
Although manufacturers are required to register their facilities with FDA, they do not have to obtain FDA prior approval to make or sell products.
That being said, the FDA requires dietary supplement manufacturers to adhere to strict regulations. All dietary supplement manufacturers, distributors, and packagers must follow Good Manufacturing Practices for dietary supplements under FDA’s 21 CFR 111 regulation.
Manufacturers are responsible for ensuring that all product label claims are accurate and for reporting any serious adverse events found to be associated with the use of these products in the United States. Adverse events can be reported through the Safety Reporting Portal.
Once a supplement is on the market, the FDA monitors reported adverse events (and takes necessary action such as issuing a warning or requiring a product recall) and regulates product labels and packaging literature, while FTC regulates product advertising.
3. Understand what Good Manufacturing Practices (GMPs) are.
The FDA itself does not certify dietary supplement products or the facilities in which they are made. There is no official government GMP seal to look for on products that indicates verified company GMP compliance.
4. Be aware of specific product safety concerns and don’t assume that “natural” means safe.
Though presumably the majority of dietary supplement manufacturers work very hard to ensure the quality and safety of their products, consumers need to be aware that adulteration (intentional tampering of a product which may be economically motivated) and contamination (a product contains an unintentional component or substance) of products still pose a tangible risk.
Many botanical ingredients used in the manufacturing of supplements are sourced from countries all over the globe. There is concern that, if these ingredients are not handled and tested properly by the manufacturer, consumers can unknowingly ingest supplements contaminated with unsafe levels of substances like lead, arsenic, mercury, pesticides, microbiological contaminants, bacteria, fungi and mold, among other harmful residues.
The Dietary Supplement Health and Education Act of 1994 (DSHEA) denotes that a supplement is considered adulterated “if it has been prepared, packed, or held under conditions that do not meet current good manufacturing practice regulations.”
The FDA Consumer Updates page is another resource for current news in supplement safety.
5. Read the label.
The FDA requires all dietary supplements to have a Supplement Facts panel (this differs from a Nutrition Facts panel on food products), which includes the name of the product, how much is in the package, who manufactured/packaged/distributed the product, its ingredients, and the nutritional constituents.
Manufacturers may also list “proprietary blend” on their label, indicating a mixture of ingredients, often making it impossible to know what exactly is encompassed.
6. Look for third-party testing marks.
Perhaps the most important thing to remember is that, though dietary supplements is a regulated industry, there is no FDA seal of approval to indicate verified product safety. The best way to ensure that you have chosen a safer supplement is to look for one that has been tested for quality and safety by a third-party certifying body.
According to the United States Anti-Doping Agency (USADA), a dietary supplement third-party testing agency should:
Be free from conflicts of interest.
Have external accreditation such as ISO Guide 65- General Requirements for Bodies Operating Product Certification Systems or equivalent, and ISO17025 – General Requirements for the Competence of Testing and Calibration Laboratories.
Conduct an audit of the supplement company to Good Manufacturing Practice (CFR 111). The third-party testing company (or another vendor if this step is outsourced) should offer proof of qualifications to conduct the audit.
Evaluate the dietary supplement for overall safety and quality (preferably according to NSF/ANSI 173 Dietary Supplements).
Have validated and accredited methods to test for prohibited substances in sport.
Some of the most well-known and trust third party marks for dietary supplements include:
If you’re interested in using dietary supplements of any kind, first educate yourself around any potential side effects and interactions, the mixed evidence on its efficacy, and other safety considerations. Speak with your healthcare provider or dietitian to determine the best supplements for your specific needs.
For more on nutrition and healthful eating during menopause, check out Lisa Health.
Lauren Panoff, MPH, RD, is a registered dietitian, freelance writer, and speaker who helps families transition to plant-based lifestyles. She can be found at laurenpanoff.com or on Instagram @chronicplanet.